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HomeMy WebLinkAboutBuilding Permit Application (2)yU P ! Q Not Applicable MORTGAGE COMPANY: Not Applicable f Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: i FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address: City: Zip: Phone: BONDING COMPANY; Not Applicable Name:_ Address: may: Phone: OWNER/ CONTRACTOR AFFIDVLT: 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 restriction 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 pools, fences, wails, signs, screen rooms and accessory uses to another non-residential use "WARNING TO OVIINEIL YOUR FAILURE TO RECORD A 'NOTICE OF C0- 1131110ENENT MAY RESULT IN YOUR PAYING TRICE FOR INPIROVENENTS, TO YOUR PROPERTY. A NOTICE OF 01 MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. F YOU INTEND TO OBTAM FNAMCIiI C, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORaI1G YOUR NOTICE OF b Signature of Owner/ Lessee/Contractor as Agent for Owner SPATE OF FLORIDA COUNTY OF The fing instrwrie t was acknowledged before me thisday of 2o_Lq by !Name of person making statement. Personally Known OR Produced Identification V✓ Type of ldentifcation K i-*5 -(dc .3 ` + `j ._ � �� f Produced ri- yr _. 0ENDOLYN I. BELL MY OM ISSION # GG 170551 W: December 25, 2021 Bonded Thru Notary Public Underwriters i Signature of Contractor/License Holder i° STATE OF FLORIDA COUNTY OF n e The forgoing instrument was acknowledged before me this 3 day of October 2o_i�L by Name of person making statement. Personally Known x OR Produced Identification Type of Identification REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW 1 DATE r 4 { RECEIVED I DATE COMPLETED Y Rev. 2/7119