HomeMy WebLinkAboutCONTE PERMIT APP1DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phone
Not Applica
State:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip; Phone:
Not Applicable
State:
FEE SIMPLE TITLEHOLDER: _ Not Applicable BONDING 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 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 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 ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature o wner/ Lessee/Contractor as Agent for Owner
STATE OF FL RIDA
COUNTY OF
The forgoing instrument was a knowledged before me
this _LL_ day of 20 -� by
Jal, ) )i
Name of person making statement.
i
Personally Known V OR Produced Identification
Type of Identification
Produced
(Signatu of Notary Public- State � •tea Notary Public State of
Margaret E Montep
Commission No. "r y _ eil} My Commission GG 2
Expires 06/05/2022
REVIEWS FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
SignatXe of Contractor/License Hower
STATE OF FLORIDACi�
COUNTY C
The forgoing instrun.jent was acknowledged before me
this J,'- day of Hu ' U,- 20,�(: by
Name of person making statement.
Personally Known L_ OR Produced Identification
Type of Identification
Produced
re olf Notary Public State of o= Notary public State
Margaret E Monte
;ion No. C-��ilL)q� �; 1) My Commission GG
'') w Expires 06/05/2022
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