HomeMy WebLinkAboutMalone AC Change out permit app pg 2 SUPPLEMEWALCOMYRUMMLA ROK)RWfATION:
f kit NORTGAGE ANY Nat Appfitabk
Name: Name:
Address: Address:
CRY- State: City: State:
Zip: Phone Zip- Phone:
FEE Sd WIKE TULE HO#DM- Nat AppfiraW BCW4=46 CO WPANY: Nat Applicable
Name: Name:
Address: Address:
City: CRT
Zip: Phone: -- Zip: Phase:
OWMER/CONTRACFORAFFRMff-.AppocatiDnishoebymadewobtwnapo..dt to do the wort acid ow as indicated_
t certify#sat no work or hmUdation has co mnericed prior to the issLmum of a permit
5t Lnde siha s rw I that is Im a p vAR qudx tze the ba�rin brld tse st ruMire
whkh Is�vft mq�dome Owne s As&Da t�bylaws or aWa�ants that mWreo or ii such
struC#ur�Please mns&uMh ymw Hmm Oemers A%opa€b=and mvww yaa deed for achy reAricliom which may
In con0d"Jon of the Vmtft aftis rewested permit I do hereby agree that I in ak reWetft,perk m the work
m aan"Imice aft tthe spored ply,the Rarida M&W[aces and St Lude Cody Affemknerits.
The foftvmig btuldft pecrruft apprkations are emmipt from undeqpft a full conctirrericy revier�r,roan addawns,
accemolry strUEDSV4 WA6=Vjft sips,screw rooms and accessory usm to anothw non-nmkkurtal use
WARNLN TO OWNER:Y4xw a to Reaaad a Nodm a racy us 1l pig twk a far
improvements to your per'.A Notice of CDnvnencement mist be recorded and posted on the jobsfte
before the first it6peCtlan.tf you intend to obtain fnarAtg,consult with fender or an atWrney before
t�ommencum vaorir or ntegEf
M ySur Notice of CommencemeaL
sknattie I i Camacmr Agantt fnr mature of CwtractwAkense Holder
A sT Boa
COUKTYof �-_ � Lucie.
The kistrumentwms ackrwwkd&d berme rm The f xwousg was�before me
this of 2p� by tlhisr dayr of �,�0 2i by
Mow f. &4 le. Vickad F 1,
Narrle of lame of sta t
Persarha�y Knwvn Prot� �d h Pam►Kno OR
wn Produced klOnfiftafiGt
Type of Mien Type of 1deribTication
Produced Produced
ftnatwe of r c WE JaYLE cokws�t i� r eta!of )
Notary Public- Florida L1dR1STI�E JQYLE CO
Commissiorh NO. mission Moot
f My Comm,Ezpins Aq 23�2024 a�� u�•Stets of Florfda
r` commisslon N GG 984701
SondaQ through Motional kotary A><sn. n My Comm,Expire A 1 4
r at al kotsry Assn,
REVIEWS FRONT � SUPERVWR PLANS VE€�ET MANGROVE
CDUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
7
DATE
4701
RECEIVED
DATE
COMPLEfEll
Rev.8/2/17 _