HomeMy WebLinkAboutPermit.1711-0690SUPPLEMENTAt� G N5"� U? " iQ.N . I N .
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: ERIC KUEGLER
Name: RICHARD WHITEHEAD
Address: 10725 S. OCEAN DR. 424 JENSEN BEACH, FL 34957
Address: 1D725 S. OCEAND R. #24
City: JENSEN BEACH State:
City: STUART State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address: 7984 SW JACK JAMES DR.
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 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 toy(ujr property. A Notice of Commencement must be recorded and posted on the jobsite
before the first ins ctio . If you intend to obtain financing, consult ith lend r o an attorne before
com^ncjng worIqqJr rechrdingour Notice of omme ceyrlent,
Signature of 04miirl Lessee C 0-htraVior as gent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA I
COUNTY OF
STATE OF FLORIDA A��r
COUNTY OF IV��
ti
The forgoing instrument was acknowledged before me
this 2C i day of C})�'(`)j' _20by
The forgoing instrument was acknowledged before m
this 2� day of NC tl2m {�.i , 20 by ;;�••
Name of erso akin statement
ersonally Known VOR Produced Identification
ype of Identification
roduced
v
01 %✓�
Name of pe rso making statement
Personally Known 1/ OR Produced Identification410
Type of Identification
Produced
C�, c� WZ
'
2 u
o Co D
Signatu e of Not ry Public State of Flor da)
mmission No. (Seal)
(Signa ure of N tary Public -(State Florida) N oma—,
Commission No, C d (Seal) m
'4
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17