HomeMy WebLinkAboutBuilding Permit Application (2)SUPP1~~M~NfAL~9NSTRUCTION~ISl\lLAW INFbRMAT~ON:c'c,.':,:.:"..•.
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DESIGNER/ENGINEER:_Not Applicable MORTGAGE COMPANY:_Not Applicable
Name:Name:
Address:Address:
City:State:City:State:----Zip:Phone Zip:Phone:
FEE SIMPLE TITLE HOLDER:_Not Applicable BONDING COMPANY:_Not Applicable
Name:Name:
Address:Address:
City:City:
Zip:Phone:Zip:Phone:
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OWNERI 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 structurewhichisincontlictwithanyapplicableHomeOwnersAssociationrules,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 vour Notice of Commencement.
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,rSignatureofco~-clntractor as Agent for Owner
5TATEOFFLO*~COUNTY OF .•5T ATE OF FLORIDA.s;.(--rJ..,-..:.COUNTY OF •
The forgoing instn~s acknowledged before me
this~day of ~~,204 b~:J?flAl 'a ~"aklnz s a me
.,
Name of person rnak _
Personally Known OR Produced Identification _
Type of Identification RD
Produced _LL.-
Name otperson m _
Personally Known OR Produced Identification
Typeof Identification t::i.D
Produced '---
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DATE
RECEIVED
MANGROVE
REVIEW
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR I PLANS I VEGETATION
REVIEW REVIEW REVIEW
SEA TURTLE
REVIEW
DATE
COMPLETED
Rev.8/2/17