HomeMy WebLinkAboutInspection Docs PERMIT# ISSUE DATE
e' FI.MiMWG&DEVELOi'IVIEW'SEk.'WOES
Building&Code Comp]—nee Division
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]BUDDING PHEW=
SMCOI T CTOR AGREEMENT
(ft� Z e 7r, c- have agreed to be
(Co any Name/Iudividuai Name)
the l ec-I't,z / Sub-contractor for W!y rm .e t)e&e_ too-11+ ew,. fc 1/f
(Type of Trade) (Primary Contractor)
For.the project located at ��- \ J �-e� R
(Project Street Address or Property Tax ID#)
It is understood that,if there is any change of status regarding our participation with the above mentioned
project,the Building and Co&Regulation Division of St.Lucie County wffl be advised pursuant to the
filing of a Change of Sub-contractor notice.
CONTRACTOR SIGNATURE(Qualifier) 4WICOWRACTOR SIGNATURE(Qualifier)
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PRINT NAME PRINT NAME
of e
COUNTY CERTWATIONNUMBER COUNTY CERTINICATION NUM�E�R�
State of Florida,County of �V'�l,�r State of Florida,County of B B i s+c -L
T[ie forregoing instrumentt was signed before me ibis day of The foregoing instrument was signed before me this^`- �day`off
20Q ;2017 byVJ�Q�ICA V� U
c
who is personally mown or has produced a :+-.,. who is personaily hngwnY/_or bas produced a
as identification. . as identifieation.
STAMP STAMP
Signature ofNotary Public Signature of Notary Public
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PelitName oMotary'Public Print Name of Notary Public
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for r Notary NOW
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malow,Lyle Wynn@. Robert Ludlum
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PERMIT# LISSUEDATE
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Comfort .�o-n.trral •of St. 'Lucie Caunty, Irac.. have,agreed•to'be I
-•(Coritp�t�NgaaeliailividuaTN�p13) •
to H-VAC Sub-ac6a odor gory.
('se of Ttdde) \2�1 (�rimas3+Coxwtractoi•) -
For the&6jeol ldeat6d at_ _- \ J ` �� Ts,
- .'(Fioject Street A�d• s or? pertq Tax ID�)
It is undersfaod th t,if there is my change of status:ragarding'e&p"cipatiori with t ie abo' mentioned..
•PrOjeat;the BUildift and Code Regirlatibh Division of St.Lucie County will be advised Puismg.to the .
fli,g-ofa Change of tb-cofit ctor-notice.
CQN�'�A�['ORS�GAfA�'[)I�E(Qite6fferj. — ��Y:O - - IGNA�'Ult,L(Qu�ifier) .
'M.-a.'i�I7ety Lirle Wynne
PAW.WAlI,(E FMTNAM
C+DTJWCEBMC,ATIONwor COUMYCERTMrATIONM3MSER
Sate 0YP't4rida,aOty Of-2 zi c E State of Florida;County of Si aci
The fo►�going instsbnrersttvs�s.tighed before me this day of +, The fbreplmg indramentwbs sWQI-bd&e me oY
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as ldcntification. ag idea wAtion,
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DQROTHYANN BASKIN
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f3 MY COMMISSION#GG 030145
EXPtRE$:OdtobeP 2,2020 r; MY COMMISSION#GG 030145
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ST: LUCIE COUNTY .
BUILDING & ZONING
i
2300 VIRGINIA AVENUE
FORT PIERCE;FL 34982-5652
772-462-1553
FILLED`LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property:
#1 306-1 1 1-0001-000/0; 6.17 34 '49 n l 1 tbat sari- lying
(Tax ID/Legal description/Address) northeasterly of I-9 5
for which I have applied to St.Lucie County for a Final Development Permit. In accepting
this Final Development Permit,BP Number ' ,I acknowledge that as owner of
the above described property,and in accordance with Section 7.04'.01(D),St.Lucie County
Land Development Code, I shall be responsible for assuring adequate drainage so that the
immediate community WILL NOT be adversely affected. I further acknowledge that in
granting this permit for the development of this property,St.Lucie County is neither obliged
nor liable to provide,for,or maintain in any form,adequate drainage off my property which
will not adversely affect the immediate community.
Matthew h yl T. �ynnP
Property Owner Name Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF S t_ L U C 12
ACKNOWLEDGED BEFORE ME THIS DAY OF 20-
BY Matthew Lyle wynncz WHO IS PERSONALLY KNOWN TOME OR WHO I4AS PRODUCED
AA r AS IDENTIFICATION.
NATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY
(SEAL)
NOTARY PUBLIC TITLE COMMISSION NUMBER
EKE
State of Florida 'n GG 038942
2020