HomeMy WebLinkAboutSeams AC Change out permit app pg 2SUPPlEMENTALCONSTRUCTION LIEN IA.W INFORMATION:
DESl6NER/ENGINE -Not Applicable MORTiiAGE COMPANY: _Not Applicable
Name: , Name:
Address: Address:
City: State: City: State: ----Zip: Phone Zip: Phone:
FEE SIMPI.ETIRE H01.DER: -Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
Oty: Qty:
Zip: Phone: Zip: Phone:
OWNS(/ mN'IRACR)RAFRDVlf, ~4illtalif>P 's hereby made1D obtain a pennitto dothewod<and RISI 11 7¾. '"" ino.cated.
I certify that no work or instalJation laas UHIWte...ai .,riorlDtheissuance of a permit.
St. Lucie County makes n,:, 1q11 ttatit,n that is granf!Rg ape.mit will authorize the Denllil:holderto bald the~ s1ructure
• which Is in mnllictwilh;111t<'P!llhble 'une OWner; "155'• ... ion~ h¥1aws orand aN5lilfds tbatmay reslrictarprpbibitsuch
S1ructllre. Please consult lliilli your Home OWoer.. Assvi:iatiu,, cdld reliew younleed for ilhy 1esuictions llihidl inav apply.
fn LOtlSideiation of the g,a.1ll11g uf this requested permit. I do hereby-that I will, in al ,espe, Is, perio, RI the worJc
in acrordance with theappmved plans, the Florida Building UJdes and St. lucie County Amendments.
The following buildiiiig permit applications are exempt fro.., widagoiug a full CDl1CUffl!IIC.Y rewiew: room additions,
accessory slJuclliiie,, swinaniug pools. fenas, walls, signs, screen rooms and accessory uses to another llOIHe;idential use
WARNING TO OWNER: Your failure to llemrd a Notice of ConlmPa en ent ,nay result in JGIII" paying twice for
improvements to your property. A Notice of Commencement must be rea>nled and posted on the jobsite
before the first inspection. If you intend to obtain financing. consult with lender or an attorney before
commentin work or remn:li ur Notice of Commencement.
~~~~
~~~ ~Lu.cit-
Themr:goil,g~wasacknowlcdgai before me
this_f-t-_1\-da\day ~~I . 20 2-1 by
~F.Bo~
Name of personfoal:ing
Peisonau, Known _L. OR Produr:ed ldentilicalioo __
Type of Identification
Produced, ________ _
Si@ltatureof Con!ractor/tkense Holder
STAlE Of FLORIDA COUNTYOf. ____________ _
The~~--+tbdgoo tieforeme
this_fil:_dayof i\yril ,20ZL. by
,J\i~~
"l'B"""SOl"'iall\""-1 ---'---OR Pmdua!d klenlifitatio.,. __ _
Type of ldentification Produced, _________ _
REVIEWS FRONT lDNIN6 SUPERVISOR . PlANS VEGETATION SEA TURTlE MANGROVE
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
COUNJER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW