HomeMy WebLinkAboutBuilding Permit Application (2) SUPPL l TALCO LIEN WIN R ATION:
l fii/ENGINEER: _NotAppli€abie MORTGAGE COMPANY: iNotApplicabie
Name- Name_
Address: Address:
City: State: City: State:
Zip_ Phone Zip. Phone:
FEE SIMPLE a 1U hVLOM y dot Applicable BONVING COMPAW. Not Applicable
Name' Name:
Address: Address-
City: City:
21p: Phone: Zip: phone:
OWNEIV CTU A_FRl3► IT-Application is hereby madeto obtain a g eni itto do the worEand installation as indicated.
I certify that no wo:ea or installation hastormmenced prior to the issuance of a permit.
StLudeCoun rnalresrurrepresentationthatisgrantingapennitwillauthodlet€Legernsittwktertohuddthesubjectstivaure
which is in caz r VAth any app�abie home£loners Pssoaatirxi rules,t�riaws aranst covenants t iatmay resuict ar prohibit such
structure.Please wnsutt your Rome Owners AsSutiatinn and mwewr yourdeeci for any restrictions snahic.may apply.
In consideration of the granting of this requested permit I do hereby agreethat I will,in all respects,perform the work
in accortiimce,with theappraved plans,the Florida Building Codes and St.Lucie CourAv Amendments-
The following building permit applications are exemptfroma undergoing a full coneurrency retrieve:room additions,
accessory strictures,swine mutes pools,fences,watts,s"vis,screen rooms and accessory uses to another non-residential use
WARNING TOO Your failure to Record a Mob€e of£€nvitencement may re suit tn your paying twice for
i.,tprovementsto your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection.If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement
Signature or t)wrier/LessWCo - Age nt for caner Signature of Cordractor{Litense holder
SPATE OF FLORIDA STATE OF FLORIDA a ( „t.`�
c€lilisEi'9r€l st �. CCsilNTY€ F LUI.i
The fprgoitg instrument was admawledged before me The forgoiinginstrument was acknowledged before me
this day of gow abar 20" by this li, dayaf Nwem6ar 202,0 by
Michtae t f7 &I le, Wclrit d r 14
Name ement Name of perso airing star meat
Personalty Known OR Produced Identification Personally Known OR Produced tdemiCxcation
Type of Identification Type of Identification
Produced Produced
!Signature of Notary -State of Florida) (Signature of tlatary P is-State of Florida)
Comrmissioni ,'v� +. CHRISTINE JOYCE CIJ. Com aa��_ �al�
�e rNRIfT Jr Rfv rr
Notary u x•State of Florida ------ '��..Nw3...
-y �`- Nata Pu
s� Commission X GG S44701 ;y ry blic•State of fiO,iz,
,Tar h S. My Comm.Expires Auer 21,2024 t:��e;t Commission a GG 9DU01
or M1: M
an e t rou National banded through Nati al Notary Assn.
REVIEVIS () SUPERVISOR PIRr MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
HATE
RECEIVED
DATE
COMPLETED
Rev_8/2J17