HomeMy WebLinkAboutBuilding Permit app page 2Not Applicable
Name:
City: f+ pie((r State: trL,Ma,o ^ t-77rZio: altq15 Phone
MORTGAGE COMPANY: Not Applicable
Name:
Addre ss:
City:State:
zip:Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Add
City
Zip:
ress:
Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 Countv makes no reoresentation that is srantine a oermit will authorize the oermit holder to build the subiect structure
which is in conflict with anv a'oplicable Home Owilers AsSociation rules. bvlaws or and covenants that mav restrict 5r orohibit such
structure. Please consult with liour Home Owners Association and review'your deed for any restrictions Which may aIply.
ln 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. lf you intend to obtain financing, consult
with lender or an attornev before commencine work or recordins vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF //a- l-,,.-
-
Sworn to (or affirmed) and subscribed before me of
,/Phvsical Presence or Online Notarization
,n" ru-aay ot h-+*a.*- ,2020 by
F-^*r"- G. d- ),,. i.-lr.r
Name of person making statement.
Produced
Commission No.6b ry<r4"
Personally Known OR Produced ldentifi
b)i tuts
'- i. No
'%;*
Signature of Contractor/License Holder
STATE OF FLORIDA
coUNTy oF ,l/o-A,,^
Sworg to (or affirmed) and subscrlbed before me of
/Physical Presence or _ Online Notarization
this / lt day of fu- t-*.4r ,2020 by
0
€rn^,^,n h n)r^-lsL
Name of person making statement.
OR Produced ldentifi cationrl
($Bnature of Notary PubliFstate of Florida ) 7 i
li*,nirrion N,. 6 G /! TfLl? tt""tfi'4Ii:,f,i,
PLANS
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW