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HomeMy WebLinkAboutBuilding Permit Application (2) ? IN Mh WKl. opuc-roN3 �uawb } RAT N111 y DESIGNER/ENGINEER. _Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: A Address: City: State: City: State: Zip: Phon Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: A 1 4 Address: City: City: Zip: Pho Zip: Phone: OWNER/CONTRACTOR AFFIDVIT: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 that 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 covenants that 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 rooms and accessory uses to another non-residential use WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in paying twice for improvements to your property. A Notice of Commencement must be recorded in the public records of St. Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult w'th lender or an attorney before commencing work or recqrding your Notice o Comrrwncement. Sig ture of Owner/Lessee/Con actor as Agent for Owner Sign/urCo Contractor/License H der STATE OF FLORIDAc� T• ��i�L��C� STAF FLORIDA COUNTY OF COUNTY OF >ti o n to(or affirmed)and subscribed before me of Swo n to(or affirmed)and subscribed before me of P ysical Pres or O line Notarization P ysical Pre c or O line Notarizatl �day of 7 � -�A- b is �day of 28 by y a001q e Name of person making statement. Name of person making statement. q �•i Personally Knowr��OR Produced Identification Personally Know OR Produced Identification , Type of Identification Type of Identification `'•. � •'` Produced Produc TV& z{: Si nature Notar Public-State of 7FIora( g Y ) (Signature of Notary Public-State of Flo idalCommission No. e :�' EBORM11111VAW1. ©?/b rc^ `, Notary Publfen No. (Seal) P. ?, COMMISi1O N � /My COMM-EXP u REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.