HomeMy WebLinkAboutStewart PV Permit AppUWYS"E COJiPLETED FOR APPLICATION TO BE ACCEPTED
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DESIGNE NGI Not Applicable
MORTGAGE COMPANY. Not Applicable
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Name: < f� \
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Name:
Address: J
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
RONDI G P a 3. 'Not Applicable
Name.
Name:
Address:
Address:
City: pwqw,qhmFCaro
Zip: Phone:
Zip: Phone:
O E CONTRACTOR AFFIDVIT.0 Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit
St Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit (do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency rev-revieur room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TOOWNER: Your failure to Record a Notice of Commencement may result in paying twke for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with (Ender or an att9mey before commencing work or recordin our Notice!# Commencement.
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Sig ature of Owner/ L •r ee/Contractor as Agent for Owner
Sign ture of Contra 'or/Ucense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF S'F LWC A
COUNTY OF e 7rt / �C C/ 1 ---
,
Swg to (� affirmed) and subscribed before me of
Swa to (� affirmed) and subscribed before me of
,/ Ph sisal Prese ce or Online No nzation
�' Ph sicai Presence or. Online
y n ne No -on
thi ay of O by
this day of 0 by
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Name of person making ent.
Name of person making s6kement.
Personally Known OR Produced Identification
Personally Known V OR Produced Identification
Type of Identification
Type of Identification
Produc d
Produced--
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Signature of N ry ic- %ifyPtAlp &If Florida
(Sign re of Nota -
;p Kathleen O Rivera
ip'�Y °L Notary Public State
Commission No. - •. My Cos ory 9842
ctt Florida
Commission No. KathAA O j
0112
Of s Ou24/200
Ileen
�o ommission HH 089gg2
of Expires
n 01/24/2025
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
GROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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