HomeMy WebLinkAboutst lucie permit 1DESIGNER/ENGINEER: , Not Applicable
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
NOApplicable
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 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 thepermit 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
WARMING 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
commencina_weflf-Qr recordine vour Notice of Commencement.
Kev. //tul4
Signature of Owner/ Lessee/Con'tractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FL RIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing ins rument was acknowledged before me
The forgoing instcUment was acknowledged t
efore me
this day of RCentGU 20A% by
this day of 20A
4((Naa
by
(NarAe of person alcknow ]edging)
of perso acknowledging }
(Sign Lure of notary Public- State of Florida }
(Sign tune of Notary Public- State of Florida
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
-Y,KI l3ERLY MENDEZ
ac. `lea MY CD I N #GG234874
Commission No. Z, J
L 04, 2022
•► KIM
Commission No. j'4 ` MY
3ERLY MENDEZ
IQN #GG234874
EXPP
°► ` Bonded through 1st State Insurance
EX !
EX
E& JUL 04, 2022
Bonded thr
ugh 1st State Insurance
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. //tul4