HomeMy WebLinkAboutBuilding Permit Application IVOV U/ It U4:13p P•Z
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DESIGNER/ENGINEER: `Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: N a m e:PAUL ROMANO
Ad d re ss:5121 NW DUNN ROAD Address:
City: State: City: PORTSTLUCIE State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:55,MECTMORESMEET 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.
1 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 thepermitholder to build the subject structure
which is in conflict with any 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 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 i'n 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 onan attomey before
commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF_5T. LK)C:t-e COUNTY OF `,,T. I i)c A ,
I
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_J_dayof Npt_PAx.}�. 2Q_0 by this —1 dayof t� �f hnl�,d / ,20A, by
Name of person aking statement Name of persona aking statement
Personally Known x,-,' Produced Identification Personally Known ✓ OR Produced Identification
Type of identification Type of Identification
Produced Produced
( ' Lire of Notary Public-State of Florida) ig ture of Notary Public-State of Florida
rot,.%p�,eG� JAIWE L HARM 4� JAIME l HAP YE:
• MY COMMISSION JI122
Commission No. C> O� I a epOPYCOMMWION BGG ftmmission No.C�(,(�$et(a 2L . t
may, EXPIRES:Apn7 2,202 t�* t�tPu s:Apr? f
Bonded Fm6wfget Notary pf FLW Bonded TINY NOW Sryices
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
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