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HomeMy WebLinkAboutKabasan AC Change out permit app pg 2 001SUPPLEMENTAL CONSTRUCTMN UEN LAW INFORMATION: jDESIGNERIENGINEER. _Not Appii€ ble V#GAGE C€3 Amy_ _NotApplicable Flame: blame: Address: Address: City State: City: State: Zap: Phone Zip: Phone: FEE Si THE H E y Not Applicable EIGNMM COMPANY: Nit Applicable Name: name: Address: Address: City: may. Zip: Phone: Zip: Phone. tl4 ERj COMMACTOR AFROVIT, Application is hereby made to obtain a pemuttD do the murk and hilt Nation as indicated. t Certify thatno work or instaffadon has commenced prior to the issuance of a pen -nit. St Lode C©un Yy makes no rz{sresentatior, that Sgranting a ern�twill authorize the permit holder to build the su'aeci s2necture which is in cont36etwith any applicable Home Owners Association rum, bylaws or and covenants that may restrict or prohibit such structure- Please consEAwith your biome Owners Association and review your deed for myrestrictairss which may apply in consideration of the grarttingof this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance with theapproved }clans, the Ronde Budding €:odes and St Lucie County Amendments. The following building permit applications are exenV%in undergoing a full concurrency reviews room additions, n 3 .,..e a...M currmasdna a 1n faismsvans cwris a n rnnms and arcessnry uses to another nan `esidential use WARNINGTO ER: Yaw iaitore to Record a Notice of Comimencement may result in your payrim twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. if you intend to obtain financing, consult with tender or an attorney before commencing work or recording your Notice of Commencemen-L Signature or Owner/ t.asssee/Contraletcr Agent for w+re= Signjature o€ Cormactoricense Holder STATE Of A a. LUGS SCOUNTYOF TATE A a. Wd(& UNTYQFO The forgoing instrumentwas acknowledged before me The forgoing mstryment ivas ac osowiedged before me this tti* day of `�F _ .2020 by thisI�tM day of ( l�nUbi 20-4 by tictw f RIN tV1iC Name of p Cement Name of persoyfriating statilment Personally Known OR Produced Ident fication Per-Dimily Known V OR Produced Identification Type of Identification Type of identification Produced Produced mature of Notary tic -state of r4arida ) (Signature of Notary iE State of -Morida) -_ Commission Wo. ' r ... "' HRISTIN CONWELL %onimission ..,.,.r.<....... JOYCE Co • ,S Notary Public - Stci4f Florida 4+_ NotaryPublic •State of Florida g Commission X GG 584701 Commission X GG 984701 or r� MY Comm. Ex irm Aug21 2024 Bond d through Natfonai ;it ry Assn. Bonded thro jilh National Notary Ass . REVIEWS R PLANS ANGROVE -t £OUsNTsER' REVIEW REVIEW REVIEW REVIEW REVI€flL+y REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17