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TImemceMent il required.
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If-.Va ;4ii�,,Ii _�podim reo-AECORD. Commericement Wreq`uhwd.,
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DESIGNER/ENGINEER. Np.,i Ap[i>raC�fe NIOItTGAGE C{?MPANY _Not Applicab3e
Name Name
Address: Address:
City: -state, Gity
State
Zip: Phone Phone:
FEE SlMPLE'TITLE HOLDER. Not Applicable BONDING COMPANY: �IVot-App(icatle
Name: ;Name:
Address: _. Address:
w ..
City
Zip: Phone: Zip: Phone: _
OWNER/CQNTRACTOR'AFFIDVIT;Appiisation is hereby made to obtain a permifI6 do th"work and installation as indicated.
I certify that=no work or installation has commenced;prior to'the issuance of a or {t
St:_l ucie County�inafies`no.representation that'15 granting,a.pperm t=wit!auxhorize'the permit holder to build the subjectstruC#ur`e
which is.in conflict with'any applicable Home Owners„Association rules,bylaws or and covei,an#s that may restrict or pmtiibit such.
structure:Please consult with your Home`Owners Associationxand reviewyyaur deed for any restrictiocis which mayiapply:
In consideration of the granting ofithis requested perm t,i do hereby,agree fhat l will,in alljrespects;perform"the work
in accordance with-the approved plans,the Florida Building Codes`and St.Lucie County Amendment's:.
The following bullding,permit,applfeatlbns are 6kempt from undergoing a full concurrency review:.room additions,
accissorv-sfructures,•swimmQ pools,fences,walls,signs,screen rooms and,accessary uses to another.non-residential_use
"WARNING40OWNER: YOUR,FAILURE-aTO RECORD A NOTICE OF COMMENCEMENT MAY RESULT;IN YOUR PAYING „
TWICE' 'ON`TFOR I.MPROYEMEIittS TO.YOUR PROPERTY-A.NOTICE OF COMMENCEMENT MUST BE:RE€ORDFI) AND
POSTED �IJ
E OB SITEBEFORE`'THE FIRSiT-,#NSi'ECTitON. IF QU INTEW TO,,OB1A1111 FINANCN6'CONSUi.T
WITH YOUR LENDER°OR AN ATTORNEY BEFORE:RECORDING YOUR NOTICE-OF COMMENCEMENT."
Signatu�era Owner/Les- C tractor as.Agent for Owner 5Ig'nafure ofrConttacttt ease Holder,°
STATE OF FLORIDA STATE 6041.C3RIDA
COUNTY 0 5�C L-u eta COUNTY OF
The for o ng instrume t was acknowledged before me l The fo_ ol`ng;instrurnent was acknowledged before me
this I day__of_ l�G��#'20 Eby this� day of �p`c i( ,2t)�Oby
Name of `arson-miaking stateme6t.a Name of`person making statement.
Personally Kna ORRioduced identification ersonaliy Know ,OR Produced identification
tification ” kation
Produced, __ :i?roduce&-
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(Signature of Notary P=bl =State of Florida `` (Signature of,Nota'ry P illi -Sta of,TIor )
Commission No. �5;a (Seal} Cortrmissian No �q, 1. d� -
_ fitotliicY-PnDRcBtrrlidFW'ida
REVIEWS FRO- ,p' ,,;L (dB6R#s$OR PLANS VEGETA7461\1 T R ikOVE F
COUN E1J$I +;42 °REVIEW REVIEW REVIEW
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'QATE
RECEIVEU_ _..
DATE =_—
'COMPLETED,
Rev.Zf-Irt 19
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