HomeMy WebLinkAboutBuilding Permit Application Jul, 10, 2018 8:03AM
No. 0222 P. 3
" i!I R i 1;
121'' ivi
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DESIGNER/ENGINEER: r Not Applicable MORTGA COMPANY: Not Applicable
Name: Name;
Address: Address:
City., State: City: I -State:
Zip-, Phone: Zip., F-Phone:
FEE SIMPLE TITLE HOLDER! Not Applicable BONDING)COMPANY: Not Applicable
Name: Name.
Address: Address: I
City: City:
Zip:_Phone: Zip: I Phone:
I certify that no work orinstallation has commenced prior to the issuance of a ermit,
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 tha�I will,in all respects,perform the work
in accordance with the.appYovdd plaPs,the Florida Building Codes and St.Lucie'County Amendments,
The following building permit applications are exempt from undergoing a full c(incurrency 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 Racqrd a Notice of Commence ent may result In your paying twice for
Improvements to your property,A Notice of Commencement muss recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencingywork or recording your Notice of Commencement,
Signature of Qwner/_LesAsee1Co&ntractor�as &'nt�for Owner Signature offfon Wra 6-r �
cerise Holder
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STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFSTLUC19 COUNTY OF sT wc1r;
The Or oing in*strua a knowledgell Vore me Th a olnlinstru ntw k owledg fore me
this day o
20Jay this day of 20 by
CHRIS LANGEL CHRIS LANGEJ
(Name of person acknowledging) (Name of pe Son acknowledging)
1A
d)p
_ nature of Notary Public-State of Florida) - (S nature f Notary Public-State of Florida)
r.scinafly Known x OR Produced Identiflcatioq _0 Personally K own X OR Produced Identification
Type of identification Pro Type of Ider tification P
o
JUUINA L.HOFAN&CONNE.
FF941-41 W6111NA
Commission No, IFF134114111 9 MY, MON V FF 941411 Commission No. FFB4 4 0 U
064*d Thr Dwamber6,2010
EMMIDorember6,2019 941411
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
. COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS