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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