HomeMy WebLinkAboutSL2S 1ITLEMENTAL CONSTI CTI"t3N t EN [N 0 MATI:CJN
DESIGNER/ENGINEER: Not Applicable
Name:_
Address:
City: _
Zip:
Phone
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:_
Address:
City:
Zip:
Phone:
MORTGAGE COMPANY: Not Applicable
Name:
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City: State:
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BONDING COMPANY: Not Applicable
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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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER (W AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLORIDA 11 STATE OF FLORIDA
COUNTY OF L 1'�Q/L� 1t COUNTY OF
The forgoing instru Tent was acknowledged before me
this'll day of VJ— 20 r) by
Name of person making statement.
Personally Known a�o�urXdL1dgntifitiQn ,
Type of Identification OANAOWEN
Produced Notary Public - State of Florida
y4i Commission # GG 264415
My Comm. Expires Oct 5, 2022
Bonded through National Notary Assn.
(Signature of Notary Public- State of Florida )
Commission No. C� ( (Seal)
REVIEWS FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
The fo(�oing instru ent was acknowledge before me
this -7 day of 04... 20�� by
LaAkvc�uu
Name of person making statement.
Personally Known (,// OR Produced Identification
Type of Identification
Produced F
.. OANA OWEN
P f o#ar ublic -State of Florida
Commission # GG 264415
ti... My Comm. Expires Oct 5, 2022
M12� �$onded through Natiorat Notary Assn
(Signature of Notary Public"-� State of Florida )
Commission No.QD 7 �[ C� (Seal)
ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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