HomeMy WebLinkAboutBuilding Permit Application (2) L V -. _.
uP .EMENT1LCQISTUC?N LI'EfiU ,tfCRIVIfT(}N: '
�W
. .� .4 .
n
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name; �. Name.*:
Address:; Address
city' State: Ctty - State:.
Zip. Phone Zip;. ,Phone:-
FEE`SIMPLE TITLE HOLDER: Not Applicable BONDING.COMPANY:` No Applicable
Names Name:
Address:
.. Address:
-
City: City:.
Phone: Zip; Phone:`
Ow ..R/•CONTRACTO,R AFFIPVIT'A licat onAs hereby made to obtain a permit to db'the work and installation:as.indicated..
Pp
t certify that no work or installationbas commenced prior'to the issuaneepf a permit:
St.Lucie-County makes-nd representation_that'is granting a,peIrmit will"authorize the•permit holder.to build the subjectstructure
which conflicts with any applicable Homeowners Association rules;bylaws or and covenants that may' restrict or prohibit such'
structure:Please consultwith your,Homeowners Association and review your deed for'any restrictions which may apply;
In consideration of the granting of this requested permit,l do hereby agree that I wil1.in all respects,per orm the•work
in accordance with the approved.plansi the Florida Building Codes and'StAdcie-County_AmeAd,ents;:.
The.fol,lowing.bulding permit applications are exempt from undergoing a.full concurrency review:room additions,:
accessory structuresswimnilrig;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 resO in paying twice for"
improyements,to your,property_.A Notice of Commencement must be~recorded:in the.public records of St.
Lucie Co.untyand posted on the jobsite.,before the first inspection;. If you intend to,ob'tain financing,consult
with lender bran attorne before cornmencin work or recordin , our. Notice of Commencement,
serV
Signatu o r/Lesse ontractor as Agent'for Owner �a � c.c>1J �c
re
�CNa
STATE.OF FLORIDA,
COUNTY OF =22:
Sworn to(or affirmed)and subscribed:before me Of Physical Presence or Online:Notarization;
this `day. of C=� _ _. ,2f] (: by
Name ofperson making s merit: -
Personally:Known" Prgduced identification
TYpeof ldentificat'ron Produced
(Signature of Notary Public-State of Florida);
Commission NO.."tl'I4.".o)L?6) ,(Seal); �,07' Notary PubliaState of Florida
Lorraine Sortino
My Commission HH 018389.
cc Expires oaf2.d12024,
REVIEWS FRONT ZONING SUPERVISOR, PLANS VEGETATION SEA.TURTLE MANGROVE
CQUNTER REVIEW- REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED'
DATE" .
COMPLETED
ev 21