HomeMy WebLinkAboutAPPLICATION BologeorgesDESI G,-NER/ENGINEER. mot Applicable
Nam6..
Addr,e�ss:-
city: I.' State:
Zi P: 1. Phone
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FEE IMPLE TITLE HOLDER. Not App icable
Narl lw�e:
Add ess
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Z*lp: Phone:
MORTGAGE COMPANY.
Name:
Address:
city:
Zi P Phone. -
Not Applicable
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State
BONDING COMPANY.a .Not Applicable
Name:
Ad d ress:
City*
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT.5 A-plication is hereby made to `a.e'-'`...the '.'a-.'n_.�`..'_ic^tec
I ce-�.-.c./..''.±..`'co'^e''z'`-'-``a'z.a.r.`
St,, Lucie Count makes no representation that is granting apermit. will authorize the permit holder to build the.subject structure
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wh ch,is in con lict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
struct 1,re. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consWeration of the granting of thi-s requested permit, I do hereby agree that I will, in all respects, perform the work
in acc9rdance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The f9liowing building permit ap-plications 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
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WAkNING TO OWNERO. Your failure to Record a Notice of Commencement ay result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Llucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
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with lender or an attornev before co mencinp, work or recording vour Notice of Co encement.
Sig ta_`. .,`'`.`, ,` Agent for Owner
FLORIDA.
COUNTY OF . M""�44171 tow%j-
Sworn to (or affirmed) and subscribed before me of
L1 Pliysical Presence or Online Notarization
F% aQQ'rW11
t i� day of by
N me of person making statement.
P6,rsonally Known OR Produced Identification
T & .0 0
y I pe, of Identification
Pr'd-uced
110
$ignafure of N&ta'ry ubliAState
Com�niss-ion No.
Holder
STATE OF FLORIDA
COUNTY OF 6
Sworn to or affirmed) and subscribed before me of
Physical Presence or Online Notarization
go**
this day of U.- I 201� by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced-
,,ftjPLS4mature of N&ary Pubi%- StUa uf
V 0' Notary Public State of lorlda
1§�albwna Jayne Hall Com sion No.,
my Commission GG 20 585
15xpireS 04/1512022
EVIEW.S I FRONT I ZONING I S..[......
COUNTER REVIEW I REVIEW
A EE
LEC IVED
iATE
P PLETED
v. 5/6120
Not ublic State of Flonda
-''- /
/My Commission GG 20 58 5
PLANS ' VEGETATION ' SEA TURTLE MANGROVE