HomeMy WebLinkAboutPikora AC Change out permit app pg 2SUPPl.EMEHTAl.CONSTRUCTION UEN lAW INFORMATION:
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DfSl6NER/ENGINE _ Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: ' Name:
Address: Address:
City: State: --City: State: --
Zip: Phone Zip: Phone:
FEE SIMPI.E 11Tl£ HOWER: -Not Applicable BONDING CDMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OVINB/ CONlRACIORAfflDVIT~ Aj4ilil a•iw is berebynalem obtain a permitm do the work and •s• n Ji<>n as indicate<L
; certifythatnoworlc"' installal ■P' Jiasam ■,tan:.ed ,.norm the issuance of a pennit.
St. Lucie ClluntY makes nc, 1qaesmtalio.. that is grantjng a Jlll!Ulitwill aulhorize the aermltholderto build the~ structure
• which IS in mnflictwilh ~•• -dJe "loRle OWiiers Aw◄ Fil••· •ules. bylaws or amlmvenantsthatmav. R!5bict or prphibitsudt
structure.. Please consult= ..... _,.... Home OWoen, Assodatiun ..nil reuiew your deed fw any l"t!SIJictiuns 1lfflidl may apply.
In consideration of the .,. ... 1tl11g oJf this requested pennit, I do berebJ agree that I will. in aB ,e,peas, peiloun the work
in accordance wilh theapprollt!d plans. the ftoricb Building Codes and St. Lucie Counfy Amendments.
The following building permit applicatinns are exempt from midagoing a full concum,ncy review: room ..ckiilitn,s,.
ilCCt!5SOiY stiucwre,,. switmnilc pool!;, fena!s. walls, signs, saeen rooms and aa;esSOJY uses h> anotha non-residential use.
WARNING 10 OWNER: Your failure to Record a Nolk:ed C&lmim!i■ a, bit may result in your paying twice for
improvements to you• pmperty.A Notice of Commencement must be remrded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
ur Notice of Commencement. com -worltor --
~ /~L?~ ;~ '/4 .. / ¥ ~
Signature owne-?~~ror-=,-er Signature of Contractm-/Lia!nse Holder
~~o~A st LufiL, STATI: OF RORIDA st. UAC)e:,, COUNTYOF
1ht fmgoq,~ad:::rrl v-,1 l....rore me lbem~-a,•1-I dpr'beforeme
this n day of y\ • 20.zL by this day ot I • 20..u. by
~F.BoJL 2'i~%~ Nameof~ Personally Known OR Produa!d ldenlifi<alion __ Personally Known OR Produa,d kleutilkatiM
Type of klentifi<ation Type of ldentilication
Produced Procluced
~n-~ ~L 1 ~at ,,_,at ~.
(Signature of Notary . . .. " . of'6111;j~YCHONWELL (Signamreof ~1
I 1~ r:1 Notary Public: St1t• of rtortda· r-·····;,,--... \ CHRISTIN~JO~WELL
Commission No. · \ I_! Commt~,e 9!4701 Commission No. -.: ....... , ..... -·· "y Comm. pr Aut 21, 2024 ' ~ 0 "'-"·ry Public,-Flortct,
Bondld throuth NatiQ_nai.fijotary Assn. \i ~J CommisslOf\ # G<i 984701
' ··-.. ,,,o,~./ My Comm. ExptrMAut21, 2024 _
"""''a,,., ,1 .. ,1 .i..~----i.. .. . .. ..
REVIEWS FRONT IDNIN6 SUPERVISOR Pl.ANS VEGETATION SEA TUlffl.E MANGROVE
COUNIER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17