HomeMy WebLinkAboutScan_0012L.0cJ1%31VCKJC1V1,y11M Not Applicable
Name• Rlchara cobum
Address: Po Box szr
City: High spr,a5 State-, FL
,Z1p: 32655 phones 4u3748 �
FEE SIMPLE TITLE HOLDER: Not Applicable
Marne:
Address-
City:
Zip: Phone:
MORTGAGE COMPANY: Not -Applicable
Name:
Address:
City: State•
Zip: _ 'hone:
BONDING COMPANY: Not Applicable
Dame:
Address:
City:
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 work or installation has commenced prior to the issuance of a Permit_
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any {nplicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult w�t�i your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of th
e granting of this requested permit, i do hereby agree that 1 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 concurrency review. room additlons,
accessory structures, swimming pools, fences, walls, signs, screen roams 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
improvements to your property. A Notice of Commencement must be recorded In the public records of St.
Lucie County 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 recordin N `
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF iFsA.�
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this _L7 day of 2020 by
/11
Name of person making statement.
Personally Known, OR produced Identification
Type of identification
Produced
t�jgnature of Notary public- Stat 49pi
A J NOBLES
Commission No. � � � " Y PUBLIC
S OF FLORIDA
REVIEWS I FRONT I ZONING
COUNTER REVIEW
RECEIVED
A
Ex our otice of Commencement.
FSignaupr�ese Holder
STATE OF
COUNTY OFFLORIDA
Sworn to (or affirmed) and subs ibed before me of
Physical Presence or rF"online Notarization
thls ay of 2020 by
Name of person making statement.
Personally Known _ 1ZOR produced identification
Type of identification
Produced
• r% ! A
(Signature of Notary publIc- Stat ..
Ti AJ NOBLES
Commission NO Y PUBLIC
S XF FLORIDA
NO. GG360685
UPERVIS
SANGRO
REVIIEWOR REVIEW VREVi WON I SEEVIEVIiEGETATIATURTLE I
�REVIEWVE