HomeMy WebLinkAboutBlanchard AC Change out permit app pg 2 001dL[ecnv Miciv lsivv ilYt-EiIt A1lum:
Not Applicable IGE compANY: _ Not Applicable
Address: - Address:
Zip: Phone State: City: State:
Zip: Phone:
FEE SIMPLE TITU Ho€t7E � riot Applicable 8E] " CO PA _fat Apisaicable
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Address: Address'
Coy: City -
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit
St Lucie Counttyy makes no representation that is granting a terra, will authorize the permit holder to build th subject strurtuc
which in conf3ictwith any applicable Homy Owners Association rule, bylaws or and covenants that may restrict or prohibit sI
structure. Please consult with your Home Owners Association and review your deed for any restrimons which may apply.
In consideration of the grand of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance witit the approved plans, the Florida &AIding Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full mncurrency review: room additions,
accessory structures, swimming Pools, fences, walls, signs, screen rooms and accessory use to another non-aesideniial use
WARNING To OWNER- Your failure to Record a Notice icif Commencement may result In yourpaying twice for
i:nprovementstct your propertyt A notice of Commencement must be recorded and Merl on the jobsite
before the first inspection. If you intend to obtain financing, consult with :ender or an attorney before
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Signature Owner/ Lessee/Contractor Agent for weer
Signature of Contractor/Licerse Holder
STATE OF
OUINTYp FLORIDA . 1 rrpi�
OF olZEl3A �
COO FSTATE
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The fo oing instrument was acknovAeedge1 d before me
The forgoing instrument was acknowledged before me
this'% dayof M�)e( 20 Zo by
thiszf-dayoff mar 2t)?-0 by
WhaeA F Soyie,
miCyILt.Bt r`yavk-�
Warne of person . g tement
� RnProduced
Name of persa} Waking statilment
Personally Known identiFcation
Persona_ Known ti OR Produced identiiscatior
Type of identification
Type of Identification
Produced
Produced
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(Signature (, S ( u01 OOJ FdOUdg ��..
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{Signature biic-State of Florida )
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COmmLiSiOn NO. e o o aIe� • �44n1 } `:iirr
: CHRISiINE JOVCE CON'N(�
Commission 1)
State
113MN07 3)AO ( 3NILSIVH) ' Q�.t,'.*,`
of Fonda
'; `+ Commission # GO 9g4701
r•°Y, ^,.:' My Comm. Expires Aug 21, 2024
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DATE
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COMPLETED
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