HomeMy WebLinkAboutST LUCIE COUNTY PERMIT PG 2DESIGN ER%ENGINEER: _ MNot AMpplficaMbl
GMECO M MPA NOY_ Not Applicable
7Address:
Name:
Address:
City: State:
city: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: - Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
city:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: 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, ,i 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 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 RECORDA NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICEFORIMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE 'FIRST INSPECTION. IF YOU INTEND O OBTAIN FINANCING, CONSULT
WITH YOUR LEN PEWOR AN ATT RNEY BEFORE RECORDING YOUR NOTICE MENCEM :"
F
ture of`Owner/ Lessee/Contractor as Agent for Owner
' nature of Contractor/License Holde
STATE OF FLORIDA
COUNTY OF Q_C'�...
STATE OF FLORIDA , ,,
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COUNTY OF",
The for oing instrument was acknowledged before me
this j day of �i°�^ 20� by
The f r oing instrument was acknowledg—pd before me
this day of 20'C>Jby
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Name of person making statement:
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced ,�`
F—V0,01
Produced
(Signature of Notary Pu - State of Florida)
(Signature of Notary Pub -
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VEGETATION
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REVIE
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
PATE
COMPLETED
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