HomeMy WebLinkAboutBUILDING PERMIT APPLICATION GhorayebDESIGNER/ENGINEER,
Name.
Address:
City:
Zips mdnavdw�
Phone
FEE SIMPLE TITLE HOLDER,
Name:
Address:
City:
Zips Phone:
Not Applicable
State;
Not Applicable
MORTGAGE COMPANY,
Name:
Address:
city:
Zip: Phone:
a
BONDING COMPANY,
Name:
Address. -
City:
Zip:
Phone:
Not Applicable
State:
_Not Applicable
OWNER/ C011lTRACTOR AFF1DVtT: 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 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
with lender or an attorney before commencing work or recording your Notice of Commencement.
Signat- of Ow/er/ Lessee/Contractor as Agent for Owner
q re .
STATE OF FLORIDA
COUNTY OF
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Sworn to (or affirmed) and subscribed before me of
Ph sisalay of IQ Presence or Online Notarization
this dL9 �.'s' by
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Name of person making statement.
Personally Known OR Produced Identification'
Type of Identification
Produced
Sig ature of N�taryVubliMState�g,�,�c�
Signature of . C/ntractorjLicense Holder
STATE OF FLORIDA
COUNTY OF
TI I�
Sworn to(or affirmed and subscribed before me of
Ph sisal Presence or Online Notarization
this *7 ay of L 2Qqfrby
Name of person making statement.
I Personally Known OR Produced Identification
Type of Identification
Produced
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Notary PUWIc' State of flionda
9Dq5'9 5 1 Com son No.
Com fission No. 14§ealbonna Jayne Hall
* my Commission GG 20585
Et xp4res 04/15/2022
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REVIEWS
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FRONT ZONING
COUNTER REVIEW
SUPERVISOR I PLANS
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a Jayne Hall
My Comovssron GG 20758
Expires 04f15/2022
VEGETATION I SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW