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HomeMy WebLinkAboutBuilding permit app pg 2 001SUPPLEMENTAL CONST°RUCrION, LIEN LAW INFORMATION: DfS#GNER/ENGINEER: _ Not Applicable Name: MORTGAGE ANY: _ Not Applicable Name: Address: Address: may_ State: Zip: Phone CaT State: Zip: Phone: FEE SIMPLE TITLE HOLDER: a Not Applicable Name: BONDINGCOMPANY- [dot Applicable Name: Address- Address: City- City: Zip: Phone: Zip-. Phone: OWNER/ CONTRACM : Application is hereby made to obtain a permit to oa ttie wom arm insrahrauun as I certify that no work or installation has commencer prior to the issuance of a permit. ,-_ . _--- .--. _,.- _....,.,,•. thyt k amn inn a nPrmit will authorize the Dermit hofderm bvKd the sublett str in consideration of the granting of this requested permit, I do hereby agree that I Wk in all respects, perform the work in accordance moth the approved plans. the Florida Building Codes and St Lucte County Amendments. The following building pert applications are exempt from undergoing a full mncurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses is another non residential use WARNING TO OWNER: your falture to Record a Notice of Conamencemm may result in your paying tvaice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsfte before the first inspection. if you intend to obtain financing, consult with fender or an attorney before carnrerFraFl wrvFR VF aex.us us//i��//))uua aavear�. ..e ....••••••�•-..•-••--••— �� Signature of Contractor/License Holder Stgrhat33Ce OrSe2%cORtr2tt04' A$�9f f(1r caner STATE SFFittRit7 STATE OF FLORIDA a"" W CfiLINT y �f IAPIQ, COUNTY ' The forgoing instrument was admuvaledged before me Theforgoing instrument was admowiedged before me this J,1k� day of NAV. 120 %0 by this 11It day of tjh\f. , 2D'W by P,lichtant F. BQy(c� �flicln�el F �o tv Name of person terrhent Name of perso rralong state rent Personally KRoum 4a Produced identification Personally Knonm OR Produced identifiFatinn Type of Identification Type of Identification Produced Produced oyCE CONWELL (signature of Notary ? o SuteofPlorida [e©fit is-gp {S>gi3atti ELL y Comm 'ij,s-io-�� GG 9d4701 Commissioa Nn."?`_My ComrR¢laes Au; 21, 2024 iy Notary Public •State of Piorida Cnmmission NO `.., Commission gGG(9�@'J211 B.: ended through ation�l Notary Assn. ires Aug 21, 2024 " Bonded through aii'41.1 Comm tional Notary Assn. . ZONING SUPERVISOR PLANS VEG TATION SEA TURTLE MANGROVE NTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW gREVIEWS?FRONT Rev_ 812%37