HomeMy WebLinkAboutSanders AC Change out PermitSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
Caw State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name-
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACIOR AFFI#3YI% 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
St Lucie County makes no representation that is €
which is in conflict with any applicable Home Oiler
structure. Please consult vnth your Home Owners
So structure
rict or prohibit such
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 moms 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 jobsite
before the first inspection_ If you intend to obtain financing, consult with lender or an attorney before
e lIC011
nonce OT wmmencemenT_
Signature of owner/ /Contractor s Agent for caner 1 Signature of Comractor/Licens older
STATE OF FLORIDA COUNTYOF aT r.Pr�
• Loll
The forgoing instrument }}�_ sacknowledged before me
this'f�gbay of _ Oji o ?t 20 I� by
Whoo F Boy He,
Name of person/raking stAtement
Personally Known OR Produced Identification
Type of identification
{Signature of
Not&; r
Commsson
COMPLETED
Rev. 8/2/17
STATE OF FLORIDA
COl1NTY OF G-Wje.�
The forgoing instru��}e� was acknowledged before me
thisU--day of U m i i? 2019 by
Yl6LIG MlCF Doyle,
Name of persog aking stat ment
Personally Known V OR Produced Identification
Type of identification
Produced
State of Florida i
�MKIr IINE J. CONW&�Ieal
otar�- State of Florida
Commission # GG 017839
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