HomeMy WebLinkAboutSebree AC Change out Permit App pg 2 001i StIPPLEM€Ni'ALCONSTRUCTION LIEN LAW 'INFORMATION:
— muL r�ppucame, I MORTGAGE COMPANY: — Not Applicable
Haoress: Address:
City. State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable SONDING COMPANY: Not Applicable
Address:
city -
Zip: Phone:
Address_
Zip:
vvvxscng a.vr%IISURc,acsn:#rrrrttvta:Appiscatlonishereby rnadetoobtain a permitto 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 appty.
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 mast 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 wort( or recordinp vnur Nrrfirp of rnmm nrpmant
Si ff& Ire of Owner/ Lessee/( ntractor 5 Agent fOr ner
Signature of Contractor{License Holder
STATE OF FLORIDA
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STATE OF FLORIDA STD
COUNTY OF
COUNTY OF
The forggo�ing mstrue�n�t�w�as acknowledged before me
this day nf�_ 20A_9�_ by
The forgoing instrument was acknowledged before me
this tZ day of i ( ___ 2011 by
Michael F Boy le.
Icl�" F bo !e-1
!dame of person aking stAtement
Name of perso along statement
Personally Known OR Produced Identification
Personally Known V OR Produced Identification
Type of Identification
Type of identification
Produced
Produced
Qom.
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(Signature of Nota ublic- State of Florida }
{Signature f Notary blic- State of Florida }
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Comm. xpires Aug 21. 200
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DATE
RECEIVED
DATE
COMPLETED
Rev. 8/21w