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AUG-21-2017 MON 08:57 AM CENTRAL SCHEDULING FAX No. 3212686138 P. 003
MORTGAGE COMPANY, Not Applicable
Name:
Address:
City: State• City: State:
Zip* Phone: zip:—Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY., __Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: 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 perrnt will authorize theermit holder to build the subjdct structure
which is In conflict with any applicable Home Owners Association rules,bylaws or anscovanants 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.following building permit appiltations'are�xemptfrom undergoing 2 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 failure to Record a Notice of commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobstte
before the first inspection. if you intend to obtain financing, consult with lender'or an attorney before
commencin&work or recording your Notice of Commencement.
Signature of wn J Agent/Lessee Signature of Co—nTO/Aicense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF� • - CA
The forgoing inst ment w acknowledgqefore The forgoing instrument wa s acknowledged before me
k me 2- L fto&� *1by
this day of 20bp this day of 76
o Ycpj RkTA
Nice I e-
(Name orperson acknowledging) (Name of person acknowledging)
(Signature of Notary Public—state of Iorlda) (Signature of Notary Public-State of Florida)
Personally Known OR Produced identification Personally Known OR Produced Identlflcatlon
.Type of identification Produced Type of Identification Produced
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0 0
Cath
ne
Commission Nci.-�A I Commission No (Seal)
--? —ju
V17237
1; CRtherine Koillger
OCT 28,20
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1ST FLORIA"6fayacFV'ftPtMg:ocr 20,2014
Revised 07/15/2014 100NDEDTHRU
1STrL0R=140TAIt%tJ4C
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS