HomeMy WebLinkAboutRinehart AC Change out permit app pg 2SUPPLEMENTAL CONSTRUCTION LIEN U\W INRJRMATION:
D£Sl6NER/EN(ilN: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name; ' Name:
Address: Address:
City: State: --City: State: --Zip: Phone Zip; Phone:
FEE SIMPLE TITLE HOLDER: ~ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTORAFflDVIT: Ap\u ali••• is hen!b-f made to obtain a permit to do the work and installalion as indicated.
I certify that no won: or installation has commenced prior to the issuance of a permit.
St Lucie Countv makes no~ that is dllW a ~will authorize the permit holderto build the :subject structure
• which IS in conflict with ""'Y ~ble Home owll!,,,.a.:'o. ialiun rules, bylaws or and covenant; that may: restrict or JK!)hibit such
structure. Please a:msult 'Min your Home Owners Association and review your deed far dll\rn!Sbiclions which may apply.
In consideration of the granting of this requested permit. I do hen!b-f agree that I wW, in aft respects. perform the work
in aa:onlance with the approoed plans, the Ronda Building Codes and St. Lucie County Amendments.
The following building permit applications are eitempt from undergoing a fuU mnaKTl!ftl:'f review: room additions,
accessory structun!S, swimming pools. fences. walls, signs. screen rooms anti accessory uses to anotheF non--residenlia use
WARNING 10 OWNER: Your failure to Reccrd a Notice of Commeucenier4 may result in yoar paying twice 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 or-recordi Notice of Commencement.
~~~,Lr£~Y-8
STATEOFR.ORIDAc:j. l .
COUN1Y OF JI, JUI L
The forgoing inStrumentwas acknowledged befure me
ttiis ~ dav of ~d l • 20..R by
tJichaet f. 8:t'e...-
Name of personfoaking ement
PersonallyKnGwn_j/_OR Prnduaed ldenlification __
Type of Identification
Produced~--------
INE!liJmlCONWELL
ub!lc • Stitt of Florld1
slon # GG '1,101
lm>u1 ll, lDl<
at on1 'ot1ry Aun.
Signature or Co11tractor/l.i<l!n5e Holder
STATEOFR.ORIDA ,
couNTYOF :>t luc111
The forgoing instrument was acknowledged before me
this~dayof kpfil .20..B.._ by
M,~ B>v~
Nameof~ king statement
Personally KIICM!l_-'--_OR Pmdu(ed ldeulifitatioo __ _
1ype of klenbncation
Produced~---------
REVIEWS R . Pl.ANS VEGETATION SEA TURTLE MANGROVE
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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