HomeMy WebLinkAbout77111 MCCLINTOCK (2) "ANAL• :: � �� , .;�;_ _� a
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _NI
Name: Name:
Address: Address:
City: State: City:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: _Nc
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 inst
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!
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restri.
structure.Please consult with your Home Owners Association and review your deed for any restrictions which rr
In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects,perform th
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 additior
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-resi
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your payi
improvements to your property. A Notice of Commencement must be recorded and posted o
before the first inspection. If you intend to obtain financing, consult with lender or an attorne
commencingwork or recordingour Notice of Commencement.
gnature of Owner/Lessee/Contractor as Agent for Owner "gnature of Contractor/License Holder
STATE OF FLORIDA m(o I t STATE OF COUNTY OF
ORI(�� l^
COUNTY OF V Iv► C 1
The rgoing instrument as acknowledged before me The forgoing instrument was� acknowledgg�
thi ay of I 20n by thisfay of I I 20II_
'P(g }PP�u�Ll
Name of per n making statement Name of p n making statement
Personally Known OR Produced Identification Personally Known X. OR Produced Ide"
Type of Identification Type of Identification
Produced Produced
LE L
(Signature of 'Pmbto(mo�191tdFP�agQ2180 ( ignatur � 01 kA
,:; EXPIRES Jury 22,2019 •ar, a, EXPIRES 0 FF902180
Commission Ho;'." rwawo�vse Commission � � �
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DAT
CO PLETED
Rev.8)2/17