HomeMy WebLinkAboutGANNON PERMIT APP PAGE 2Name:Addres-s-:------------------
City:State:
Zip:Phone:_
_Not Applicable
OWNERI CONTRACTOR AFFIDAVIT: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 th-at is granting a permit will authorize the permit holder to build.the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or.and covenantsthat may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby.agree 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 concurrency review:room additions,
accessory structures,swimming pools-fences,walls,signs,screen r-ooms and accessory uses-te-another non-residential use'
"WARNING TO OWNER:YOUR FAILURE TO RECORD A ,NOTlCE'OF COMMENCEMENTMAY RESULT iN YOUR PAYING
TWICE FOR IMPROVEMENTS.,.O YOUR PROPERTY.A NOnCE OF COMMENCEMENT MUST BE RECORDED AND
PqSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.IF--VOUINtEND TO OBTAIN fiNANCING,CONSULT
WITH UR LENDER OR AN ATTOR EY BEFORERECORDINGYOU TlCE OF COMMENCEMENT."
Personally Known OR Produced IdentifJcation _
Type of Identification '
produced -----------
_-"---~---...~__~..a...=.r~:...-.11?b~~a '----~tB /o{~g(.
(Signature of Notary Public-State ~JilQlIIWiII~••••---~-IIo.f~W1ature of Notary Public-State 0
Commission No.GG3'i-fJ-.3d mission No~'I/)3';)'1.
FEE SIMPLE TITLE HOLDER:
Name:~_~_~-----"------
Address:_.-'--_
City:~------------Zip:Phone:_
STATE OF FLORIDA C::::=-'j L '0
COUNTY OF J-T U CJ 'L-•
,BONDING COMPANY:
Name:~_
Address:--------------=~-~----City:_
Zip:Phone:_
_Not Applicable
Signature of C~ntractor/License Holder
/-
~~~T~~F ci~O~IDA S-+L U (J e..
PLANS
REVIEW
DATE
RECEIVED
ZONING
REVIEW
SUPERVISOR
REVIEW
REVIEWS FRONT
COUNTER
DATE
COMPLETED
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW