HomeMy WebLinkAboutPermit Temporary power page 2DESIGNER/ENG[NEER: Not Applicable
Name: _
Add ress:
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Zip:
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FEE SIMPLE TITLE HOLDER:
Name:
Address:
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Zip: - Phone:
State:
Not Applicable
MORTGAGE COMPANY:
Name:
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Not Applicable
State:
BONDING COMPANY: Not Applicable
Name: _
Address:
city:_
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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 contliet 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, l 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 accessary 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/CoDaFaS Agent for Owner Signature of Contractor/License H r
STATE OF FLORIDA STATE OF FLORID
COUNTY OF �S4 . COUNTY OF
The fprgpirig instr ent as acknowledged before me
thiday of 20 aby
f Name of person acknowledging)
ti. rA o i i A, qu V.-
(Signature o otary Pubic- State of Florida }
Personally Known \ OR Produced Identification
Type of Identification Produced
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Commission Not l-lo j r^ a EXPIRESMa,
Remised 07/15/2014
The forgoing instrument was acknowledged before me
this _ y of 20 1 el by
(Name of person acknowledging)
n
(Signature of N ry Public- State of Florida }
d{nown OR Produced Identification
1,ype of I ntification Produced
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EXPIRE5 May 16.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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REVIEW
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DATE
COMPLETE
INITIALS