HomeMy WebLinkAboutBuilding permit pg 2DESIGNER ENGINEER: —Not Applicable
MORTGAGE COMPANY: NotApplicable
Name:
Name:
Address:
Address:
Clay: State:
City: S#ate•
Zip: Phone
Zip; Phone:
FEE SIMPLE TITLE HOLDER: ._.._ Not Applicable
BONDING COMPANY: .,_._.Nat Applicable
Name:
Dame:
Address:
Address:
City:
Zip: Phone:
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 worts or Installation has commenced prior to the issuance of a permit.
SL Lurie Count�yy makes no representation tha Is granting a mlt will authorize the ermit holder to build the subject structure
which is In conflict with anappiitable Home Owners Ass atlon rules, bylaws$r anccvenants that may restrict or prohibit such
structure. Please consult your Rome owners.Assoclation and review your eed r any restrrctFans whl may apply.
In consideration of the granting of this requested permit I do hereby agree that I wilt, in all respects, perform the work
In accardancewlth the approved plans, the Florida Bugding Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessary structures, swirriming pools, fences, walls, signs, screen rooms and accessary uses to another non-residential use
WARNING TO OWNER: Your fallure to Record a Notice of CommEnreme result In your paying twice for
Improv mgnts r�periy, A Notice of Commence t m a recor and pasted on the jobsite
befo the s Inspectio . If you Intend to obtain #inanci , cvnsu t kit lender r an attorney byre
i
I
j Sig 0 r I_esaee/Contractor as Agent for Owner
S nature of Co tractorJllcense Holder
RIDA
I COUNTY DF r rl i v�
STA FiDA ,
COUNTY OF
3 The going instrum8 t was acisnaw[pd, ktefQra me
The r aing Instrcrmenk was acknowied$ afore me
l day 0 C z0
this day of D s< Za llN�by
this cf . r .,, y
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Name bfperson raking statement r
Name of person making statement
i Personally known OR Produced identification
Personally Known QR Produced Identificatlon
Type of (dent€flcatlo
Type of Identification
Produced
Produced I i
`�q►Tl' PUy'KRISTIE KIRBY
�{I I11!
I
(Slgnatureof Notary P �C Fission # GG 92537
ignatur of Notary Public-Sta _Wo)Votary Public -State
y�
Y Commission ExpiresCpmmissian No. '",11„" Ober 23. 2023
Commission # GG
rTlrniSsicn Alo. %eddy Commission
October 23. 2
REVIEWS
FROND"
ZONING
SUPERVISOR
PI.4NS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
I —
Rev.8/2/17
>f loric
9Z5370