HomeMy WebLinkAboutBuilding Permit Application! IWAPP1,[C�goEO MUST F*0OWL"O"ApNICA RCINTO SE ACCEPMO
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PERMIT AI RIICA'CIQN.FflR:
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Project Name:
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New Efectrtcaf Meter Second Ele&tcaGMeter , (Aifdavit required)
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_: Itdditianal rruork tat3e;performed under this;pern! Check aN that., 0 f,
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Rtectric —Plumh ne Spnaklers Generator Roof, Pitch.
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Zip Codes Fax:. City Ste e
Phone No: d ',31 .' Zip Code Fax:
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irll.in tee s.mple Tide Holder an Heart page:(lf`differert t: tiail G�
frarn the Owner risked above)
State of County 4.tresise
!f value of aoe►st udian is 730Q ot;mrare,a REEAWED l�otiere b0coeime'nceme�
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C MOM LIEN lAV1l INFURMAT[ON'.ENGtNEER: T Not Applicable .MORTGAGE-COMPANY: of A i,cable
Name; _ PP
Addre Name;
ss: Address:.
City:
State:. City: 'State:
Phone_ Zip: Phone:
EEE:SIMPLI TITLE HOLDER Not pplicable A BONDING COMPANY: Not applicable:
Name: Name:
Address:' Address:
Gty.
Ztp• Phone:
city; ,
Zip: _ ... Phone:
OWNER/CONTRACTOR'Af=FIDVIT:,Application,is hereby made to obtain a permit to do the Work and,installation as indicated:
I certify that no work orinstallatlon'has commenced prior to.the issuance of.a permit:.
St.Lucie County makes no representation that Is granting a permityOlf authonze the ermit holder to build the subjectstructure.
which°Is-in conflict With any applicable.Home Owners Association rules,'bylaws or:an9codenants that may'restrict or prohibit such.
structure.Please consult with your Home Owners Assdciation and-r6lew your deed for any,restrictions-which may.appiy.
In consideration of the granting of this requested permit;I do herebyagreethat I will,in.all,respe.ts,perforrn the work;
in.accordance with"the approved plans,the Florida Building Codes'and St.Lucie County.Amendments.
The following:buiiding permit;appiications are exempt from undgrgoing a full concurrency review:room;additions;
accessory structures swienmiii - ools.fences walls si ns screen'rootnsaand accesso uses,to angthernon=resideritieJ use gP g N
WARNING TO OWNER:Your fiailure.to Record.a Notice.of Commencement may resutt in paying twice f6r
improvements,to your':property,A Notice:of'Commencerrient must be recorded ,n 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.oe an ettorne` before commencin work or recordingour'Notice af:Commeht'ement: .
Signature of Owner - see - ntractor as;Akent,for Owner
STATE OF FLORIDA
COUNTY OF 5-r. vct E
Sworn b. .,or affirm i vd subscribed'before me of Physical Presence oc. Online Notarisation:
this ay'of � 20K 6y
Name of peso eking statement:
Personally Known OR Produced identification
Type, entification'Produced!
(Signatur aryPubllc=State ofF,lorida:)
+�r>•`��6" JAUNE ORTIi
Commission No. �" (Sea t'�. Motaryl�ubik State of FiWitla
Commistim+ GG 229a4a'
MX Comm':Expire3 Jue t3,2022 :
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Bonded`tArauph Nationa(Wotarp Aw
REVIEWS FRONT ZONING SUPERVISOR,' PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW 'REVIEW REVIEW REVIEW
DATE
RECEIVED'
DATE
COMPLETED
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