HomeMy WebLinkAboutScan- St.Lucie permitingDESIGNER/ENGINEER: _ Not Applicable
Name:_
Address:
City:
Zip:
Phone
State
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:_
BONDING COMPANY:
Name:_
Address:
City:_
Zip:
Phone:
Not Applicable
State:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: 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 perrrlit.
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 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: roam 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 IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT"
i
Signature of Owner/ Lessee C Va6tor as Agent for Owner
Signature of Contractor/ icens Holder
STATE OF FLORIDA
COUNTY OF 5-- L_ JC-J 'e
STATE OF FLORIDA a
COUNTY OF St- Lu(lie
The forgoing instrument was acknowledged before me
this t day of i 2Qco0 by
The for Ding instrument was acknowledged before me
this day ofi { 20 by
Sc6k
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known [,----OR Produced Identification
Type of Identification
i Type of Identification
Produced
Produced
," P" KELLY MACHADO
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KEttY �IACHADQ
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y Commission # GG 004ka6
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Commission No.
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Commission No. — Ci C)o (Seal)
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REVIEWS
FRONT
ZONING
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VEGETATION
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DATE
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DATE
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