HomeMy WebLinkAboutloc 2MEM LAI! ii`vF'ORMAEu`rb
L"
tMot App
Crave:
Address:
City: 517 Kate:
Zip: Phone:
5gMVL l7li! LCA HOLDER.- ® blot Applicable
Name:
Address:
City:
Zip: Phone:
R/ ®G"3`ra AGE C®RVG R9r:
Narhe:
Address: state: .a
City:
Zip: _,_.�.----- Phone*
Bomooms CODUIP 'W'. —Not Applicable
Marne:
Address:
City:
Zip: Phone
I certify that no work or installation has commenced prior to the issuance of a permit.
St, Lucie County makes no representation that is granting a permit will authorize the Kermit holder to build the subject structure
which is in conflict with an applicable Home Owners Association rules, bylaws or, an
covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed For any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The fallowing building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your ftfluve to @ motteTO of cunt manceyine tt mny rwult on youlr payifis twice for
improvements to your property, A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consi't With lender or an attorney before
commencing work or recording vour !Notice of Commencement.
ignature of Owner/ L essee/Agerit
STAUE OF FLORIDAeCOUN7V OF
-
The forgoing Instrument was ac cnowledged before me
this day of A :-» - v 20 L2 -by
43�, C..J I e_'? r-,
(Name of person acknowledging i
(Signature of (Notary Pulilic- State of Florida )
Personally Known V__OR Produced Identification
Type of Identification Produced
Commission No. �
MIKE MARTIN
Revised 07/15/2014
RMEWS FRONT
COUNTER
DATE
COMPLETE
WITIALS
CDUV\\9'TV OF
The forgoing instrum pit was a nowledged before me
this i day of 20 La 7 by
(Mame of person acknomedging )
_ _1nS
(Signature of Notary Public- State of Florida j
Personally Known OR Produced Identification
Type of Identification Produced
4vmmIastoii 0 FF 216951
My COMM. Expires Apr 5, 2018
rut` B,�d rllnx�li IWIIOIIff I+iOt AS
ZONING SUPERVISOR PLANS
REVIEW REVIEW
al:
No. MIKE MARTIN
Notary Public - State o1
My Comm. Expires Apr 5, 201
VEGETATION I SEATURTLE I 6�liANGROVE
REVIEW REVIEW REVIEW