HomeMy WebLinkAboutPermit Application - Delneky_Akos - PSL County✓ t"
IN
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DESIGNFR[ENGINEEPZ: Not -Applicable
MORTGAGE COMPANY, � Not Applicable
Name:
Name
Address,
Address:
G(ty _ fate
City:. State; _
Phone
zip. Phone:
FEE SIMPLE TITLEHOLDER: ' Not Applicable
BONDING COMPANih Not.Applicable
Name:
Name:
Address..
Address .
Clty;
City:
Zip: Pihonec
Z.ip:.. Phone:
OiigNER% CONTRACTOR AFFIDVIT: Application ls.hereby made to obtain a permit:to do the work and installatlomas irrdt4atoil..
1. eertifythat no -work or Installation has commenced prior to. the Issuance of a'permit.-
Str Lucle Countyy makes no representationthat.is granting a permit v�+ill a prize the permit holder to build the<sublect sttructure
byaws
whrcltisfn conflict with any applicable Home Owners Assoc>aation rules, or and covenants that may restrictor.prohibit such
Please owners
structure. consultwlth your Home Association and review your deed for any restrictions which lrtay apply,
In consideration of the.granting of this requested permit; I do hereby agree that I wili;dn all respects, perform the work
in accordance with:the.appraved plans, the'Florida 6tuildink.Codes and St Lute county Amendments.
The:folloirJingbuilding'perrititapplications.are eXemptfrom uhdergoing afull concurrer<cy_review; loom additions,
accessory structures; swimming pools, fences, walls, signs, screen rooms and accessory. uses to anothernon-residential uso..
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
(mprovementsto.yourproperty. A Notice of Commencement must. be recorded.in the ppubllc.records of St.
Lucie County and. posted on the jobslte before the fiirst inspection. if qou: niend..to,abtaih financing, consult
with lender or art ttbrney before: commeji9ps work or recording your Notice of commencemont.
(fie'
tLire�0 e�/Cpr0actw as:Agent forowner
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Signature of Cuntrector/Livens older
':.
ST4tuv FLORIDA
STATEflF FLORIDA
COUNTY OF Pat sttuaa .
COUNTY OF: Pain aw§
Sworn to (or afiirmed).and s .h cribed before me of
sw.q� to (or affrMed) and subscrlbed.befo.r Woof.
ysical Pr once: or � Onhng Notarization
✓ Physlcal: Prese. ce or Online Notarization
�f.al
.this: clayof, . , 202q by
#.his .day of, 7FM2020 by
Chtbtwher'st"
Name of person.making staternd&.
Name of person -making :statemep t,
i
Personally Known .. oR Produced, Identification,
Personally Known xx. OR Produced Identification
Type of IdLintilip4lorp
Type of id ntfi .tion
Product
Produced
to
SOME go
Not r P . tlo-:Scat f Notary Public S
(Signetlon
to ar oral y P G- StBte f i 'd� °�'Y Public
Jennifer Sc
Ili g r Jennifer is S
hi
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My Commission
Commiso. Expires 10/08l2
to
C� 914855 • My Commissio
2SOrrftni'iSian' a: cd'9»ass Expires 10l08/
0
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REVIEWS
FRONT
ZONING-
SUPERVISOR
PLANS
VEGCTA7ION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
*REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED.
DATE
COMPLETED'
ev:: 1
�f Florida
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914855