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HomeMy WebLinkAboutBuilding Permit app , page 2DESIGNER/ENGIN _ Not Applicable Name:_ Address: City: Zip: Phone MORTGAGE COMPANY: Name: Address: City: Zip: Phone: licable State: FEE SIMPLE TITLE HOLDER: _ Not Applicabl BO G COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: one: Zip: Phone: O R/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as inclita . 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 . ­­4; 1%n AV ATTnneli5tv RFFnDF RFrnRniNr.. YnUR NOTICE.A-COMMENCEMENT."-1) 1�11n IUUK LC Signatu e of Owner/ Lessee/Contractor as Agent for Owner Signa of Contractor/License Holder STATE OF FLORI / STATE OF FLORID 1 COUNTY OF�i�i% COUNTY OF r7//�I The r,,�,o,��ii��g instrurr� nt was act owledged before me 20o by The fro g instru ent was a knowledged before me this ay of t 20�Q by this�!l=ctay of �C Name of person making statement. Name of person making statement. Personally Known OR Produced Identification ✓J Personally Known OR Produced llq�gtification QOS Type of Identification. 0I-ue JESSEDO—� Produced �Gf� n�:� Commission#GG26306 Type of Identificatio ��.•"'•�'� Commission#GG Produced/-7/—Id �''� Expires September ExpiresSepternber27,20 a7iF Q on ded Thu&idget Notary Senk A 2 M''FOF.c Bonded lhruBudget No s //��\J (Sig Notary Public- State of Florida) (Sign of Notary Public- State of Florida ) /''rram�// Commission No. � (Seal) Commission No. • � l5� (Seal) l REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/19