HomeMy WebLinkAboutSuarez AC Change out permit app pg 2SUPPLEMENTAL CONSlRUCTION-UEN lAW 1NFORMATION: . ' .
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DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
.
Name: Name:
Address: Address:
State: State: City: --City: ---
Zip: Phone Zip: Phone:
FEE SIMPLE TITl.E 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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohi-bit such
structure. Please consult with your Homeowners 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 appfications a re 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 Reami 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 attorne before commencin work or recordin our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE Of FLORIDA ~L r ""'; COUNTYOF ___ J(_-. ~----";._e., ___ _
✓Physical Presence or __ Online Notarization Sworn to (or affif1Hed) and subscribed before me of
this~ day of (JCf6r£C . 20.1d._ by
Name~~""•g;,~1~
Personally Known ✓ OR Produced Identification
Type of Identification Produced._~---------~
E JOY~,ONWELL
lie • Stattof Floridi
Commission No. ---.l~bik-Jli!/ a ommission # GG 984Z01
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
.... .... y Comm. Expi res Aug 21, '2014·
· Bonded through National Mmry Assn.
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR PLANS
REVIEW REVIEW
VEGETATION
REVIEW
SEA TURTlE
REVIEW
MANGROVE
REVIEW