HomeMy WebLinkAboutBuilding Permit Application "�+T�..;'�"`„`ye',_ "r�krr��.'}'A Yi ,{.,;n.J1u °'•;1`;± -+ �%':.# -�-^�,L e ay'`4'+MB.` 'ra:,s'Y3:-. � '�a' '�'�'�`3�'�t^h'�� rY.a��
DESIGNERIMIGINEEk Hot Apprcable MORTGAGE COMPAPI of Applicable
Name: Name:
Address: Address:
City: State: State:
Zip: —Phone Ziip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: VNot Applicable
Name: Name:
Address: Address:
Zip: Phony. Zup: PBuane:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated-
1 oertafy Raaf no mmr9k or installation has commenmd prior to the imonce of a penift
St"[Lure C vena m " tart its®mate a puma a�9 to bald saa slruca ure
=N,Ch i�iam r'�2it�oitt}fi am *0 ix bie} wne o rkers Ammetian Wks,,ll my ms or and emVETMM ttltnatr
omw
structure-Please consult vAth your Home Owners Association and revarew your deed for any restrictionswhi�F�or
Such
In consideration of the granting of this requested permit,I do hereby agree that 1 will,in all respects,perform the work
in accordance vWth the approved plans,the Florida Building Codes and St Lucie County Amendnmmm
The following buMM permit appEca hoes are exemptfnm undaToaft a hall cmMmffnmxy ram ffow a
acuesmtry sbuxtfze�,$ubwnbg 06ak famms,u2ft,Asms.swe e n ffawm and ameswffy uses to anudw moaKesr emlt2o MM
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 you intend to obtain financing,consult vAth lender or an attorney before
commencing work or recording our Notice of Comme
A 1C.4 Uj _� �7
Signa Owner/ enc Sgnature of ContractorAkense Bolder
STATE OF(FLORIDA ' "�t SPATE OF FLORIDA
COU .OF )) �� tJ s_t LFA COUNT Y OF 4 Luo"r,
The for oing ins meat was acknowledged before me The forgoing instr ent was acknowledged before me
day of 20 this dab+of 20�by
(Name of erson acknowledging) (Name of person acknowledging
",�Cx', I AA1
(signature of trllotary Public State off Florida) / (Signature of Notary Public-State of Florida
Personally Known Old Produced Identification M Personally ICnotvn OR Produced Identification. V
Type of IdeniffiGation of Identifir
Pmd=0 o�•L
b.l �L ,� N �
.s i<A121 N —
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Comm ission No �s'`� �� e§�mmo�sm fss'ion FFP (� mission No.� `a'_ l< 5' S. NIELSEN
NiY. j 2 12, 20118 J*�' xc �11,rnmission i F 115637
'Jun \uM� Ccm
• @ ' , GF"o• 'lE4FG=F `' mission Fzpires '
`
REVIEa'nd^S FRONT ZONING SUPERVISOR PUNS VEGETATION SEATURTLE
COUNTER REVIEW Rte` EW REIAEW REVIEW REVIEW REVUEW
DATE
RECEIVED
DATE
COMPLEfCED