HomeMy WebLinkAboutFeather Creek AC Change out permit app pg 2SUPPLEMENTAL CONSTRUCTION UEN lAW INfORMATION:
DESIGNER/ENGINEER: -Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: .. Name:
Address: Address:
City: State:~ aty: State:
Zip: Phone Zip: Phone: --
FEE SIMPLE TJJ1.E HOlD£R: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
aty: City:
Zip: Phone: Zip: Phone:
OWNER/ OONTRACTOR AFFIDVIT: Applkatioo is hereby made m obtain ii permit m do the work and inslallalion as indicated.
I certify that no worlc ...-iDsl:affalion has commenced prior m the issuance of a permit.
St. Lucie ~~kes no re;:: ::s llilta.n that is gram!ng ii~ wUI authorize the uermit holder 1D build the~ structure
• which is in with -...,.. al.le Home Owiien Ass,-ia!h1 rules, bylaws or and covenants 1hat mav. R!Sbict or ~ibit such
structure. Pleaseconsult_t,..,,with..,your-Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the g,a11tiligofthis requested permit, I do hereby agree that I will, in aU respects, perform the work
in acmnlance with theappro,ied plans, the Florida Building Codes and St. Lucie c.ounty Amendments.
The following building permit applications are exempt from undelgoing a full conmrrenc:y review: room additions,
accessory strudures, swilmiilig pools. fences, walls, signs, screen rooms anll a,. esw ~ uses m another non-<esidential use
WARNING TO OWNER: Y-failure to Reaml a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be reconled and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencilll!: work or remnfirut vnur Notice of Commencement.
~/~L?~A ~--~./¥~
Signa~ Lessee/Contrac:tor~ ~ Signature of Contractor/Ucense Holder
STATE OF FLORIDA 'St.Lucie STATE OF FLORIDA ~-Lu.dl COUNTYOF COUNTYOF
The forgoing instrument was adm~ before me
this~ day of MMti\ . 20i-\ by
The fmgoing instrument was acknowledged before me
this.l.:!=__dayof Mov:ch .20z.1 by
Mid,aet f. Boite.--M,cmet F. ~
Nameof~ ement Name ofperso~sta ent
Personally Known OR Produced ldenlification __ Personally Known ~ Produced klentificalion
Type of Identification Type of Identification
Produced Produced
{Vw;~J~u,e ~~'..€
1 ~ > ·-
(Signature of Notary-.u'-{_ -·-· . . . {Signature of Notary • . '
1 ;;.i!•·~ CHRISTINE JOYCE CONWELL
Commission' _,~ ii,;•... CHRISTINE JOYCE CONWELL ~ Commission No. fl,• \ Notll'/ Pl,wi);tatt of Floridi . \ ···•·-· ?ubilc•Stat1olr,I)•
\ ~i Commission# GG 91•701 '-\Wl commlulon, GG 914 01 . \,. f'i, . ./ My Comm. ExplrM'.lu1 21, 202◄ ·,1 '""/ My Comm, Expire, AUi 21, ll'
"'"""aondtd thrOU11h N1tlonal Not,I'/ '""· •, .. "·"it.-.r:., ~., National Motary ':
REVIEWS FRONT ZONING SUPERVISOR Pl.ANS VEGETATION SEAlURllE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17 •, -
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