HomeMy WebLinkAboutSmidt AC Change out permit app pg 2'
SUPPLEMENTAL CONSTRUCTION UEN lAW INFORMATION:
D£Sl6NER/EN61NEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: ' Name:
Address: Address:
City: state: --City: State: --Zip: Phone Zip: Phone:
FEE SIMPI.E TI1l.E HOlDfR: ~ Not Applicable BONDING COMPA.W: _Not Applicable
Name: Name:
Address: Address:
Crty: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACr()R.AFFIDVfJ''. Ap, Iii al••• ls hereby made to obtain a permit to do the WD11< amt installation as indicated-
I O!rtify that no wort"' insl U liun tias commenced prior to the issuance of a pemrit..
St_ Lucie Countv make; no~ that is grant!ng a~ will authorize the permit holdertn build the~ structure
-which is in tonllict 1llith any~ Home Owners.•,,,.., iilliioo ,we,;, bylaws or atd covenants that may R!5trict or Jll'!)hibit such
structure. Please consult lllilfi your Home OwnersAssociation and review your deed fonmyresbiclluas which may aiiPIY-
ln consideration ofthegiailh.gufthis requested permit, I dohereby,weethat I will, in all respecls. perform the work
in accordance with the appfOlll!lf plans. the Flonda Building Codes and St Lucie County Amendments_
The following building permit applications are exempt from undergoing a full mncurrencv review: room additions,
accesso,7 stnn:1llreS, SMlmtq pOOls. fences. waBs, signs, screen rooms and aca,ssory uses to anothernon-n,sidential use
WARNING TO OWNER: Your failure to Reami a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobslte
before the first inspection.. If you intend to obtain financing. consult with lender or an attorney before
comm -work or recordi ur Notice of Commencement..
Personally~~ l'nldua!d ldeutifil:atioo __
Type of Identification Produced,__ _______ _
Signature of Contractor/license Holder
STATI: OF FLORIDA ~ I I ,. ,.;
COUNTY OF -Jr, u,<,Ul,
The forgoing~ was aclmowledg1'd before me
thisL!W,:davofJ'Sl'N .201:L by
M,cw.tel F. ~
Personally "::!perr~tification __ _
Type of Identification
Produced'-----------
{Signature of
Commission N
REVIEWS FRONT ZONING SUPERVISOR . PLANS VEGETATION SEA TURTLE MANGROVE
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW