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HomeMy WebLinkAboutBuilding Permit Application -pannbaa sl;uawaouawwoo Jo aol;oN U3MIOD3u e`aaow JCI OOSZ$sl uol;pna;SUOI Jo amen JI 90E6EE6000 :asuaoll MunopJo aiel-S (anoge pals!I aauMO ay}mum. woopoaalgepaogei(w@o papuenn :I!e1A1-3 Iuaaa},}!p}!)aged;xau uo aapIOH aim aldw!s eel u! II!3 .1CE-90Z-ZLL oN auoyd :I1eIN-3 V698-906-ZLL :xe3 6 6Li'E :apo d!Z .3Qc )_ /j—Z Z .0N auoyd ld:ale2s iuowaa10 :�(�!� :xed CJ 61b6�E :epoJ d!Z •aa nneseuua>! 9856 :ssaappy �d:a�e�S `aaaa!d]pod :MID (011 `2ib'IN OM/0 4°O2i algepaoj`d AW :Auedwoj Zia !u!11 !8 WZ:ssaJPPy yon.pa spa :aweN (41asIeH 1-18u9)-s-1 se!pedojd Nae aweN ' ' :NOflV2i!NOD. :33SS31/83NN10 :10!0H gu!pl!ne aldas l�l l Jamas— :sa!p!I!1a 989j7 $:uo!pn.ilsuoD Jo}sod :aoo13;sa!d 40 •-3 •aS :uonan.i�suo�10 l3 'bS Iel°l yo}!d joo,1 Z/is loou pi ao}e.iauag— saapluudS— Su!gwnld [_] o!a}aal3 0 so sono ui nI I sla n — Su!di seue se I— I a/ P .M I � �� yS .d 9n �I 1 g D`dnH� I I :Aidde TT{''lie�loayo—�!waadlls!y}��aapun pawaopad eq oi./JOAN Ieuomppy . :NOIlW J OJNI NOIIJf1211SN:OJ. a6pa Op `s6ulysel} `slleu `sal6ulys sse16.1egg Ile}su! `Aeijapun opq uAs `sal6ulys Jo/cal I, go Jae' :)IIOM JO NOI1dIHJS3a a3lId130. :ap!S 401 :ep!s NSW : peg }uoad sreq}aS 141asleH ueu8 066d aweN Pefoad '°N)13018 :aweN ueld a1!S •°N 101 E-000-Z860-609-COVE :al laaaed :#al xei Avadoad (ZL86-ZZ9E 2i0)by LZ'O) LEONV 9E SlO1 L>118 a/S SW1Vd VNIO HC :uo!}d!aosea 031 Z86K 1d 'aaaa!d J°d `3AV 2130NISAV8 178E :ssaappV . :NOI1VJO1 IN3W3AQUTAII Q3SOd021d au!I4o pa an 2 MOJJe Noll°. `xogdojp wail pales of :2103 NOLLVJIlddV IIW213d ,)< Ieguapisa2l IePJawwoD SLSI-Z917(ZLL) :Xed £SSI-Z9t7(ZLL) :auoyd ��a�'�ho Z86fE 7d ao.ra►d Vod'anuaAv o!u►la//I 00EZ 4i,L J uois►n/a uo/.fo/n6ag apop pun 6u!p/ing Paap 4�;Is saorn.�as luawdo/anap pun 6wuuo/d '8t 4' '' , uoileD!Iddd *wad 2u!pIIn8 N.41;14117/4 . /1/407 , 40o/ :JagwnN ;!waad :area 031d33D1/38 01 NOIIVDIlddV 21Od a3131d WOD 381ST V OWNI 318VDIlddV 11V SVPIN VORTAL-CO.;�S RU C_�ION tlIEN ILA1N�I�RhF©�MATIOaN '� �� 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: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. I certify thatno work or installation has commenced prior to the issuance of a permit. St.Lucie County makes no representation that isgranting 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 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 your Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 'LL / L COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of ,20_ by this day of ,20_ by /301YU0.1't.--) Name of person making statement Name of person making statement PersonallyKnown OR Produced Identification PersonallyKnown OR Produced Identification X Type of Identificatio Type.of Identificatio Produced Produced 0)-\ L__)\ Qj-t (Signature of Notary Public-Statetaof add Bene (Signature of Notary Publkc tate lm 0 � id �nnett �o •. o NO R PUBltCso � TrgA Commission No. NOTARY U IC Commission No. oQ[(r'� _STR*NCIF FLORIDA �� o STATE� � - `kiVii* 11 RIDA - s�t1.�.�►i Comm#FF952012 Comm#FF952012 s/NeEr0� Expires 1/2072020 N tie► Expires 1/2012070 REVIEWS FRONT ZONING •SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE - RECEIVED ' DATE COMPLETED Rev.8/2/17