HomeMy WebLinkAboutSIGNATURE PAGEOWNER/ 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.
5t. Lucie County makes no representation that is granting a permit will authorize thepermit 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 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature tractor/License Halder
STATE OF FL9XlDA
_ Not Applicable
MORTGAGE COMPANY:
PFDESIGNER/ENGINEER:
Not Applicable
Name: Janice Chouinard
The fo�r$�ing instru ent was acknowledged before me
this LY day of Cc •f— , 20L2by
Name: Geary Steve Adams
Address: 4105 Smakey Pines Court
<,—
Address: 4105 Smokey Pines Court
City: Fort Fierce
state:
City: Vero Beach
State:
Zip: Phone
Produced
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
` Not Applicable
BONDING COMPANY:
Not Applicable
Name: _
(Signature of Notary -
Name:
Address:
Address: 1206 8th Street
City:
Canmissipn a FF 989141
City:
My Comm, ExpirmMay4 7020
Zip: Phone:
REVIEWS
Zip: Phone:
ZONING
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.
5t. Lucie County makes no representation that is granting a permit will authorize thepermit 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 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Rev. 8/2/17
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature tractor/License Halder
STATE OF FL9XlDA
STATE OF FLORIDA
r�
COUNTY V Jir
COUNTY OF �l�i 4 ra � + y 0 i
The f rgoing instr ent was acknowledged before me
this day of � L 4 30 /) by
The fo�r$�ing instru ent was acknowledged before me
this LY day of Cc •f— , 20L2by
/VC—S<,—
<,—
Name of person making statement
Name of P� rsonang statement
Personally Known OR Produced Identification
Personally Knov Produced Identification
Type of Identification
Type of Identification
Produced
Produced
ELIZABETH EVANS
• W&Y Public -State of Florid
Commission a FF989142
{Signature of Notary Public- S Mill" UP4544y4l,i 2
(Signature of Notary -
jf1YR"' ' ELIZABETH EVANS
Commission No. Notary l+Al)italeofFlmda
Commission No. (Seal)
Canmissipn a FF 989141
My Comm, ExpirmMay4 7020
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SEA TURTLE
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DATE
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COMPLETED
Rev. 8/2/17