HomeMy WebLinkAboutBuilding Permit Application (2) DESIGNERJENGINEER: 'Not ApplicableMORTGAGE'COMPANY:, Nat Applicable
Name:.._.
Address:_ _ Address;
_
City; State: Cray; MStote::
Zip., Phone _ Zip:
FEE sLMPLE TI U MOLDER Not Applicable BONDING'COMPANY: Not Appiica le
Name; _ Name: ..
Address' Address: .
CityCity.,
.
.Zip:_ Phone- Zip:; __ ,Phone:
OWNER/CONTRACTOR AF!"IDVIT*Ajiplication is herebymade:t.aobtaina penin to do=the,work and instaiiation as indicated:
I eertlfjr that no work or Instattafion has.corr►menced prior to'tlie issuance of.a permit:
St.i_ucie Counttyy-makes riffs reptese>itationttiat is granting a permit will;authorize tits permit holder to budd.the subject stri[ct_ure.-
.which,is iii conflict with any pooliiicable_HomeOwners.Associat on rules,bylaws,or and covenants that-may-restrict or prohibit s"uch
structure;Please consult with your Horne Owners Association afid review youndeed.'for any restrictions.what,rriayappIV..
In consideratlonof'the grantiing.ofthis requested permit,,I do hereby agree:that i will,yin-all-respect's,'perfarm'the work
in accordance with the;approved pli'ns;'the Florlda Building Codes arid` .t.`Lucie;County Amendments.
The fallowing building;permit applications-ate exetmtfrom undergoing o full prtcurrency-reVidwi room additions,:
accessorystructures,swimmingpools,fences,walls,signs,screern,rooms acid accessory uses to another-non-residential use:
WARNING TO 01NNER.{You_r.(allure
taRecord a Notice_of Commencement may,riesult In your paying Wtefor
-=6h*
Ht'nts to your property.A'Notice of Commencement must;be recorded:and pasted,on,the jobsite
before the first inspection. If ou intend to,obtain financing,:consult with lender or an attorney before
Commencing work or recordin our Notice of Commencement.
i azure of owner/Lessee/Contractor as.Agent.for Owner SI ature�of Contractor/Ucense Hoiden
STATE,OF FLORIDA. s STATE,O!F T ORI`DA
COUNTY OF - _ r4kr1 COUNTY OF
Theforgoing---instruinent:was acknowledgobeforeMe the:forg6ln' irtstrumentwasackriowiedgei before,me
this ,day of�{; �.._..__.20M by this:] day of kamn
SC 17 4
Name of per on making statement: ; Name of personrib*in statement:
. i
Personally Known C}R Fcad"aced identificatioi f,sonally'Known OIt;Produced Identification,
Type.ofidentifcation T' f.Id' tifieatioh
'
Produced ._ � Pr cede D.d.. _
(signature of Notary.Public-Stat .091004 Z:(s natur of Nota"rjt Public-State of Fiorida
r ►itIGHAEL NEIL 6ERRARD'
Commission No; =°t` eatt)MI�ISSION#GG12621 ommissoit Ido. (Seal)
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" Bondedthco h.tsNStatelncwn _
REVIEWS FRONT 'ZONIN01 SUPERVISOR: PLANS VEGETATION SEA TU TLE' MANGkE
COUNTER REVIEW' RE-VIEW' `'REVIEW REVIEW' REVIEW REVIEIIY
DATE'
RECEIVED
DATE
COMPLETED;
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NACHAELNEXGERRARD
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