HomeMy WebLinkAboutBuilding Permit Application 'U T }
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DESIGNER/ENGINEER: X .Not Applicable j "MORTGAGE.COMPANY: _x Not Applicable~`
Name: !Name:
Address: Address:
City: .State:. City: State:
Zip:: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable: BONDING COMPANY: X Not Applicable
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Name.. Name. —
Address:. Address:
City: City:
Zip: Phone: Zip: Phone:.
OWNER/.CONTRACTOR'AFFIDVIT: Application is hereby made-to obtain a•permit to db the work and installatiarras indicated.
I.certify that no work or installation has commenced.prior to the.issuance of.a:permit.
.St;Lucie Countyy makes no representation that is-granting a permit will authorize the permit holder-to•-build the'subjectstructure
which is in.cordliet with any applicable Home'Owners'Association rules,b-ylaws:orand.covenantS that may restrietbr prbhibit�•such
structure:Please consult with your,Home Owners.Association and review your deed for any restrictions which may apply.
In cbnsideeation of•the granting of this•eequested permit I do hereby-pgree 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 concurrendy 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
rrlprovemerlts to,your property. A Notice.-of Commencement must be recorde:d'in . e public records of:St..
Lucie County and posted on the jobsiite before the first inspection.If yo.0'intend�.to obtain-financing,consent
with Lender or•ani ktor.ney before:-commencin work-or-recording our Notice.of.Commencement.
Signature of 0w,er./'I:essee/contractcr as.•Agentfor Owner Signature of Ck6fracto"r/License Halder
STATE OF FLO.RfDA STATE 0.1=FLORIDA
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IV7Y OF l�'� l�.t_l�r��o COUNTY.OF ,
Sworn to(or affirmed).and-subscribed before me.of Sworn to(or.affirmed)-and.substfted before me of
Physical I?resence or Online Notarization Physical Presenc or Online Notarization
this .day of-'CC >>�ll 2020 by thi 11 .day of ,2020.by
NP.t 1 lr �l Vie_�L lC
Name of person mak''ii/ng.statement. Name of person making statement.
Personally Known OR-Produced Identification Personally known.._OR Produced€dedtification-
Type of Identification Type of identification
Produced Produced
(Signature (Sigma r tari �5t Flo da'}
MWEl'1,REID MYCOI4iMISSION-#'H[�10769
MY COMMISSION#-RRI107
Commissi. ¢� 1} EXPIRES rnr,P�S X024 .Seal}
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REVIEWS FRONT ZONING SUPERVISOR• PLANS. VEGETATION'- SEA-TURTLE MANGROVE
:COU.NTER REVIEW REVIEW REVIEW REVIEW
REVIEW REVIEW
DATE'
RECEIVED
DATE
COM .LIFTED
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