HomeMy WebLinkAboutBuilding permit app, pg 23/12/2021
busby permit Epp 001 Jpg
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S1. FPPL'EMENTAL CONSTRUCTION LIEN LAW INFORMATION:
iNEER: Nat Applicable �DfStGNER/ENG MURTGAGf COMPANY:
Not Applicable
:nmte: 84GName:
Address.ww't Address:
. . .. .................... ....... .... .............. . ....... . ..
C ty: TAWA State: F,�oCo. State,.
zo: - � . Z Phone:..-..
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W 41-
FVE SIMPLE TITLE HOLDER. Not Applicable BONDING COMPANY; Not Applicable
Name: x
AHdress',Address;
city.
- ------ ------ Z.
Phone. zip: Phone:
O"E'R/CONTRACTOR AFFIDVff !.1 iron �s hereby made to min a p .ram to do the work and installpation as i-ndicated.
I reftify that no � � $on mas comme prr tot ssuance o a permit.
St. Wcie Cxwnty mikes no representation that is granting a ,permit v�rill authorize the rmit holder to build the subject structure
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v�e� t� is ire � Ott r�e�ih any �p��wcable Home Oww« Assvc�t�w► rules, bytaws or a covenants that may restrict or prohibit suchstr tiu�e. Mease cv�ns4aa#i wr#F� ytxtr Home Owners Association and resew your deed or any restrimOns which may apply,
In cp'nsideration of the granting of this requested ptrmrt. I do hereby agree that 1 w1"11, in all respetts,, pefform the wow
in accordance m1h the approveil Oam the Florida BiAkiing Codes and Si. Lucie County Amendments.
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Tho f6#owing building permit applications are exempt from undergoing a fug! concurrency review: room additiQm
���ry structures, swir�*��ng pools., fences, ���1�, signs, screen rcfoms and accessory ups to ar�c3tfi��r can-�esa�ntial use
WAR'NING TO OWNER: Your fa-dure to Record a Notice of Commencemefrt may resuft in paying twke for
improvements to your propeM.- A Notice of Commencement mist be recorded in the Public records of fit.
Lucie County and posted on the Jobsite before the first inspection. If you intend to obtain financing, consult
its lender ovan attormey before commencing work or recordina your Nice of ommence-ment.
Sig'nature Of Owner/ tessee/Carttractor as Agent for Owner Signature of Contractor/ ense Moider
S�'ATE Of FC A ' � �,'STATE OF FtDUNTY 0�'V1�.Jl`�-' COUNTY OP
�Q (E�f ai�'t7,� �i"� St1�3S�rl� �1��3�i`E' meof
a Ongne N IalilatFO.�
N m* of persor. m3king statement
rso ally K� � .: � Identification
pe of 1-dent"l-ficatFon
(4t' ' C cf Notary Public` State tyt Ft'r,;��
Cown': rrtOft NO ►� ,. .o 0_-ate -rJ
i �EVIEWS
S�to �rr dfF'trmed) and subscribed before me of
a( Pr��,YN�
ir�e Ntariz�t�o�day Qf202 by
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Name of oerson nuking stateovwA
Persona1'V Known � OR Produmd Identification - - - -----
ype of Identificatiw
Produced
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= of Notary Public- State o Floes
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• ��v .,OR PLANS VEGETATION
�a�"�tr, tikl+Qco° ;IeW LREVIEW REVIEW
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