HomeMy WebLinkAboutbuilding permit (2)DESIGNER/ENGI
Name:_
Address:_
City:
Zip:
Phone
Not Applicable I MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Ap NDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and in ation 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 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: 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
TWICE FOR IMPROVEMENTS 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 ATTORWY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEM;P."
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Sign&fure of Owner/ Lessee7ontractor as Agent for Owner
Contra
STATE OF FLOR�11,DA STATE OF FLOrIDA
COUNTY OF J n lLf, n COUNTY OFF V 1 Ot di r)
The forgoing instr ment was acknowledged before me The fcrr oing instrument was acknowledged before me
this) 5�Zday of 20j�)o by this 7 ~day of , 20o?o by
Ad a,m cwr,,+V�
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification 4 S
Type of Identification (�
Produced i1 o r-i d Q 0 L
(Signature otary Public- State of FW,6���c WRY LEE MA7TI
Commission No. (
�r ^ c , ,�J / q q * MY COMMISSION # GG
�ce Nor `a EXPIRES: March6,2
"OF FAQ Bonded ThN Budget Notary
REVIEWS FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Personally Known OR Produced Identification
Type of Identification
Produced l-10 r iC1a-- b L-
4%1 d
(Signature c0 Notary Public- State cgV%r't4 MARYLEE MATnS
�4 MY COMMISSION # GG 0&
Commission NoL_t__ � 's r eaaXpyZES:March 6,202,
" fYiCeS Bonded ThN Budget Notary Se,
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW