HomeMy WebLinkAboutapril permit page 2MORTGAGE COMPANY: il/nNot Applicable
Name:
Address:
City: _
Zip: _
GINEER: r/4 Not Aoplica
FEE SIMPLE TITLE HOLDER: t//A Not Applicable
Zip: _ Phone:
lqfuNotApplicable
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 srantins a permit will authorize the permit holder to build the subiect structurewhich is in conflict with any iipplicable Home Owfrers AsSociation rules, bvlaws or and covenants that mav restrict rjr orohibit suchstructure. Please consult with riour Home Owners Association and review'your deed for any restrictions uihich may apply.
ln 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 recoided and fosted bnihe;oUiite
before the first inspection. lf you intend to obtain financing, consult with lender or an attorney bef6re
commencine work or recordi of Commencement.
Sigirature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FTORIDA
ioururv o i-'---l5;/ /**)r,
The forgoing instrument was acknowledged before me
this y'$ dpy of 4A4zr/e/4 ,zo/f, by
Name of person making statement.
Public- State of Florida )
Signature of Contractor/License Holder
STATE OF FLORIDA
couNTYoF !/./, e
The forgoing instrument was acknowledged before me
this /Lday of JAaura-u4!, zo/p by
Name of person making statement.
Known 1/ OR Produced ldentification
(Signature of Notary Public- State of Florida )
!,Y COMMISSION r
EXPIREE Arna il5.[,rrcOMlvnSSiCN { FF244a
EXPF{ES;unc eS. aOll
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
SEA TURTLE
REVIEW
DATE
COMPLETED