HomeMy WebLinkAboutSand Dollar Villas DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: 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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and 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 following building permit applications are exempt from undergoing a full concurrency feview: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 jobsite
before the first inspection. If yov intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Si ature of Owne /Lessee Contractor as Agent for Owner Sig ature of Contra r/License Holder
STATE OF FLORID STATE OF FLORID
COUNTY OF � COUNTY OF n
Thef nginstrum t wasacknowledg d efore me Thef nginstru nt was acknowledged�iefore me
this d y of 20 by this May of 20 _��l by
Name of per on making statement Name of per making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
( Q Q P �'Yl Pam_ offiA
(Signature of Notary Public-State of Florida (Signature of bI1 AS:WAE4f C�ECrNE
? ASHLEE M L RANENA b MYOOMMISSIONCommission No. :j' ea Commission o.FF902180 i�oriXe$;EXPIRES July 22,2019 ��arr
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17