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�-1 �y t,i �: �Gi - F- r9 M �#i_.tf .�t� � �� �ii�h•Ff �F*�}1..rii�L ti.4 �i;���} fMrtara.f�i-rr��r[CJ
Name:
Address:
City: State:
Zip; Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City: City:
zip: Phone: Zip: phone,*
OWNER/ CONTRA, CTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and
I'certify that no work ormi
k.
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
City: State:
Zip; Phone.•
BONDING COMPANY:
Name
_Not Applicable
Address:
nstallation has comm
enced prior to the issuance of a permit.
installation as i
ndicated.
-h
*t ect
St. Lucie County makes no representation
Association o rules abyaws or andize thePcoveerminants tf�at may restscbuild the Utbor prh bitwhich is in conflict with.any app „_ .____ „____;�.:,,,, ,,,,a review y,,,,� dee� for any restrictions which may apply.
structure. Please
In consi
in accor
consult with your home�wnersr+a����d����� a��� �-• - derof the granting of this requested permit, i do hereby agree that I will, in all respects, perform
dancewith the approved plans, the'Flor*da Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full oncurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
_.
_Noticeo�Commencri,ont n,au-r.2Sult in Paying twice
the work
use
such
fa
Record
WARNING TO OWNER: Your ilure tq a ����•�.�� , • �---- impro
to our property: A -Notice of Commencement st e recorded. in the 40 pubiic records of St.
Lucie sty and posted on the jobsite before the first ins } C 10 �I�you fi�sf�rzf t o-obta�_n�financin 11111111
mg, consult
with end an atto[al bnt
efore commencin
Signature f Ow er/ Lessee/Contrac or as Agent for Owne
STATE OF FLORIDA
COUNTY OF
N�Lo,rk,or r r`dm
swo to (or affirmed) and subscribed before me of
� Physical Presence or Online Notarization
this j_�day of c 20�:A)by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Pub 1 Ic- Na ry Public StateStateOf 00F�0dO
� CaRnela Frantantoni
Commission No. �� ���'�'�� � •�� �"missionHH006820
aF ExplFes C)610412024 - -
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
ev. 5/b/ZU
VOIVOLECe UI �.01i�ici�
VIM
rf
All
ignature o Contr or/License Ides
STATE OF FLORIDA P1
COUNTY OF �YL-1-�►'� -
Swope to or affirmed) and subscribed before me of
✓° Physical Presence or Online Notarization
this 1,_�day of A V-V 20M440, by
_,�UA
0009000"� MP
Name of person makings atement.
Personally Known OR Produced Identification
Type of Identification
Produced
ignatur.Te of No
tary Publicot IONjPubic State of Florida
Carmelo Franlantcni
!jjon HH mmission No4�j 0 V r/ ExY��5661o4r2p2q 006820
PLANS
FRONT ZONING
COUNTER I REVIEW I
SUPERVISOR
REVIEWREVIEW
VEGETATION SEA TURTLE
REVIEW REVIEW
MANGROVE
REVIEW
1h
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