HomeMy WebLinkAboutmcampbell.app 1DESIGNER/
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FEE SIMPLE TITLE HOLDER:
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OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 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, I do hereby agree that 1 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 review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice 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
iAii+k Icntinr nr nn nttnrncv kafrnra rnmmanrina wnrle nr rornrdino vnur Nntire of Commencement.
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Sign re of Owner/ Lessee/Contractor as Agent for Owner
Signatur f C ntractor/Lic nse older
STATE OF FLORIDA
STAT OF FLORIDA
COUNTY OF � Ck"'k- Qe�
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn,to (or affirmed) and subscribed before me of
(n Physical Presence or Online Notarization
Physical Presence or Online Notarization
this day of (t C 2020 by
this it day of U G 2020 by
Name of person making statement.
Name of person making, statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Ty Identification
Type of Identification
P oduce
Produced
(Sign ur of of
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(Signatur o Not
PtiSt Y)n11.BELL
Commt 'on No.
_� MY cOMMISS�N� 170551
Commissi0 o.
MY MISSION # GG 170551
=" ate: EXPIRES: DeV25, 2021
if, D 25, 2021
Bonded firu Notary Public Underwriters
'�F °• Bonded Tlxu No Public Underwriters
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