HomeMy WebLinkAboutMontella AC Change out permit app pg 2SUPPLEMENTAL CONSTRUCTIONUEN LAW INFORMATION:
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INEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: --City: State: --Zip: Phone Zip: Phone:
FEE SIMPlE TITlE HOlD£R: -Not Applicable BONDING COMPANY: _Not Applkable
Name: Name:
Address: Address:
City: Oty:
Zip: Phone: Zip: Phone:
OWNER/ CONIRACIORAFRDVIT: .-ppfil ation is hereby made ID obtain a permittDdotbewmf<ai.d io1s1 8 liw as indicated.
I certify that no -OI ---· ........... -K.1!11 prior ID the issUance of a permit.
-~~,!;ifi•~=w;~o;.it;;tf.;~::,~~~~::::~~~
structure. Pleaseconsultwilfi your Home OWnersAssodalion and review your deed far ~•esbictions ,;ti;di may apply.
In consideration of the granting of this requested permit. I do hereby agree that I will, in all ,e;pects. perform the worlc
in aa:onlance wilh the approued plans. the Florida llllilding Codes and St. l.uCie Cot.mty Amendments.
The following building permit applications are ecempt fron, "'ideflloml! o full Cllllalffl!ftey review: romu additions,
accessory struclUres,. swimming pools, fences, walls, signs,~ rooms and a, • • y 11SeS to anolher non-residential use
WARNINGTO OWNER: Your failure to Recold a Notice af Caau1d!lscement,dllY ..-It in yos paylngt.wice 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
co · work: orremrdi Notice of COmmencement..
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STA TE OF RORIDA 5L r , , fl ;.L
COUNTY OF I\ ' t,..W'.,1
The forgoing instrument was ad:nowledgaj before me
t111s~11ayot Mmh .20" bv
~a~~~~nimaooa
Type of tdei1tilication
Produced~--------
Signature of CbidJddul/lkmse Holder =~A Bt-. wci~
lhefoigoing lnslrument was atknowledged befote me
this~dayot March .20..±1 by
~~~~ Pelsorlally Known OR Pmdua!d kleutifitatiou __ _
Type of Identification
Produced~---------
{Signature of Notary of Ronda) ..
Commission No.-~!\\ CHRISTINE JOYCE CONWE
:._ ... ; rlOlil' Public St.ti of Flo .r:---~! CommlHlon JGG9S4701
~d'/ My Comm. Explrts.Au121, 2024
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REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR . PLANS VEGETATION
REVIEW
SEATUIUI.E
RE.VIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
REVIEW REVIEW