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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: 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 1 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 : :iorkorrecordin2NotiC of Commencement. v . w S _Signature of Owner/Lessee/Agent ture of Contractor/License Holder STATE OF FLORA �L� STATE OF FLORA, COUNTY OF J� IV c4COUNTY OF a I0,, g Aad The forg ing instru en was acknowledged before me The forgoing instrument was acknowledged efore me this 2day of mf ;r•! , 20 by this 013 day of A pri 1 ,20 1r by (Name of person acknowledging) (Name of person acknowledging) lif 110"----- ra" _dim ill 'lsw ignatu : • -'Public-State of Florida) (Signature •'Notary.' blic-Sta - of Florida) Personally Known OR ProsikIced Identification A Personally Known -- OR Produced Identification Type of Identification Produced rlvc# /ICe•ad Type of Identification Produc;edPu., dmr.Ea,vnLinin : • $ i3I)END�AN BCARL c ����°��'• F MY COMMISSION R FF 951069 Commission No. 'Z k Z r5pa�) fission No. i:` �_ Ex� ��i�2.2o20 / : NtY COMMISSION#FF3Ki00 >3 d :n'?{ ems sT -`"``'e` �' v8 'OF Ft., Bonded i nru Budget Notary Semves -;�' t EXPIRES February 11. ?02A, (40/)3)8-0'b3 Flondallota-ySe,4c,, on. Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS