HomeMy WebLinkAboutAlton AC Change out Permit App pg 2 001SUPPLEMENTAL CONSTRUCI-ION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Address: I Address:
City. State: City: State:
Zip: Phone Zip: Phone -
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY: Not Applicable
Address:
City:
Zip: Phone:
Address:
Zip: Phone:
a W114tKI LUX i NAL I UK AFtELi§7it: Application is hereby made to obtain 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.
SC Lucie Count%makes no
which is in conflict with an
structure. Please consult v
the rmftholdertobuildthesubjectstructure
ran covenants that may restrict or prohibit such
led 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 Budding Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency, review: room additions,
accessory structures, swimming poops, 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 jobsite
before the first inspection_ If you intend to obtain financing, consult v ith lender or an attorney before
commencing work or recording your Notice of CommencPmant_
Signature of Owner/ Lessee/Contractor Agent for caner
Signature of Contractor/license Holder
STATE OF FLORIDA L r , •
STATE OF FLORIDA
COUNTY OF
COUNTY OF UI ,
The forgoing instrument was acknowledged before me
The for Ding instrzameat was acknowledged before me
this Aid day of OUV be( ,20 rq by
this ,sir dayof_octoby- .20_t�_ by
luichael F Boy le,
Wcw F I¢'
Name of persoroaking stitement
Name of perso7fnakjng star meat
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
LX
{Signurg,vftaip, - e
{Signature of Notary tic --State of Florida)
8
+°» `�: Notary Public - State of Fbl ii
fom
GG Oi7t#3'�'
Com siQ?p�pi[XU CHRISTINEJ. CONWEL(Seas'"
Aug 21, 2020
=1hrough
+�'s Notary Public -State of Florida'",
nal Notary Assn.
= Commission GG 017839
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REVIEWS
FRONT
ZONING
SUPERVISOR
P
P�,^ Bantletl hro
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MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COIYIPLETED
Rev.8/2117