HomeMy WebLinkAboutSL4DESIGNER/ENGINEER:
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FEE SIMPLE TITLE HOLDER:
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Not Applicable
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MORTGAGE COMPANY:
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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 nonresidential 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 OR -AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA In
STATE OF FLOTA 4 -
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COUNTY OF
COUNTY C 7vV ,
The forgoing instru ent was acknowledge�!-before me
The for oing instrument was acknowledged before me
141
this'lyday of , 20 by
this day of i 20 R by
4whan o d4u) _
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Name of person making statement.
Name of person making statement.
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Personally Known P. d i tin
Personally Known V O
Type of Identification ."Al o� ... oANA 4wFN
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Produced ';: 4ti.. Notary Public - State of Florida
Type of Identification :.�Y FLe .. pANA OwEN
,. ` `. Notary Public, State of Florida
Produced
Commission !t GG 264415
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Commission { GG 2644i5
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f , Bonded through National Notary Assn.
P.anded through National Notary Assn
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ignature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida ]
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Commission No. (Seal)
Commission NSI+ (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19