HomeMy WebLinkAboutaPPLICATION 2Name:
Address:
Oty: Gate:
Zp: Phone:
FEESMPLE
Name:
Address:
City:
Zp: Phone:
Not
MORTG4GEO0MPANY: Not Applicable
Name:
Address:
Oty: Sate:
Zp: Phone:
Name:
Address:
City:
Zp: Fhone:
I certify that no work or installation has commenced prior to the issuance of a permit.
3; Wde County makes no reDresentation that is orantinannsrmit Will PiifhnrI=fhan
a subject structure
rlct or prohibit such
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 8. Lucia County Amendments
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessorystructures, sAdmming pools, fences, walls, signs, Susan rooms and accessory usesto another non-residential use
WARN]NGTO OWNER Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to 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 your Notirp of r'nmmanrpmPnt
STATEOFFLORIDF�
ODUNTYOF fi .4
The fo,�ggIngInstru entwasadmowledgedbeforeme 'n mstrujpentwas acknowledged before me
this yof . QnJAQA 202Lby this The —for d'a'yof�)Gn1 A 120ZLb
(Name of person acknowledging) ("a of person acknowledging)
ORRoducedIdentification _ Per nr
acted a of
Commission No. '--`"" ,' O'MS" IO #G6241369 Commission
„<T E.xpIRFt.: October 19. 2022
ORProduced Identification
MY COMMISSION # GG 241369
Bonded Thm Notary Pul& Uuderwrifus