HomeMy WebLinkAboutMcIntosh AC Change out Permit App pg 2 0011 aurrLtmtr l AL LUNSi RUCTION UEN LAUi INFORMATION: -I
Address:-
City- State: .
Zip: Phone
FEE SIMPLE THU HOLDER: � Not Applicable
City:
Zip: Phone:
MORTGAGE COMPANY: — Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY. —Not Applicable
Address:
,i i r ria.iasie rrriuvia: Application is neretry 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 €
which is in conflict with any applicable Home Ows
structure. Please consu4t with your Home Owners
may
such
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 turice for
improvements to your properly. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection_ If you intend to obtain fsnancina- consult with Ipndpr nr an nttnn,M,
Lill
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Signature of Owner/ Lessee/Con ctor Cs Agent far caner Signature of contractor/License Holder
STATE OF FLORIDA C L�J A �g FLORIDA
COUNTYOF �I c�T
The forgoing instrument was acknowledged before me
this f .'5jk day of Urj\fo U— 20_ff_ by
Michael F. &i le.
Name of person king StAtement
Personally Known OR Produced identification
Type of identification
Produced
C,,kC �n e g. d -x u
{Signature of Notar}(,Liublic- State of Florida)
�nnwnrvt J. CONWfLL
Notary Public - State of Florida
"md-g, My C ium. Expires Aug
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., RP1IT7
The forgoing instrument was acmowledged before me
this fC�A dayco�fNVQkI QIJl zr 20by
yVt_%Ckm F &vie,
Name of persoLt freaking statement
Personally Known �✓ OR Produced identification
Type of identification
Produced
State of Florida )
c.ornmis , - o-s ��nia uNE J. CoN
s any PubliC - State otFl
M Commission a GG 01783_q
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Bonded ihr u h N Y ' 20
PLANS 6 Ass . ANf�RO
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