HomeMy WebLinkAboutBUILDING APPLICATION PERMIT Wegman
DES-IG,NERIENGINEER.
FEE S'`^`'TITLE-'�-'�'` Name:
Address:
Citv: .
zip: ^'``':_
Not Applicable
Not Applicable
MORTGAGE COMPANY.
Name.
Address:
City:
Zip: Phone:.
BONDING `.�'..A..�
Not Applicable
---.Not, Applicable
OWNER/ CONTRA OR 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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
8'
which is in con fict with any appl' cable Home Owners Assoctation 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 the work
` accordance with the approved plans, the Florida `..`, Codes and St. Lucie County Amendments.
The .'..',..�'.`�.','-''-`'-...-`.^`a'.-..'``.�,,..._���_
ac_ssor.structures, swimming pools, fences, walls, signs, screen rooms z.accessory uses. , another non-residential use
WARNING -,.`-'E.'Your failureNotice.-`..'�.''`result �.....g.wi.'.'
improvements to your property. A Notice of Co en -cement must be recorded in the public records of 5
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain finanding, consult
.with lender or an attorney_before commencing_work or recording your N,otice of Com encement.*
Signat4re 1.of Ow as Agent for Owner
STATE OF FLORIDA
COUNTY OF
-ftT- i 0
Sworn to (or affirmed) and subscribed before me of
PhAsical Pre nce Online Notarization
W?; Mw by
thi;pq day of 4
W_
0
Name of person making statementO
Person'allyIdentification.",'- ''-�..`�____`
Type of Identification
Produced
�'.a`~' of N4taryVub1*1MState.AU4 i
Sig ature of - ntractor/ Lice n se Holder
STATE OF FLORIDA
COUNTY OF/
Sworn to (or a_,_,` and subscribed of
Physi cal Presence or Online Notarization
this day of f- - __AC*0*7 PCOMW 2Q?Cr by
'VIL n
Name of person makih.g statement.
Personally Known OR Produced Identification
Type of Identification,,"
Produced
iarjaWre of N&arv%PubM4- St
1070,7595 0 Notary Public State of lorlda
Com ission No. .c loom - albonna Jayne Hall Com sion No.
My Commission GG 20 585
Not Pubhc State of Floril
'7
a Jayne Hall
v My Commission GG 20-758
Expires CW15/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
REC IVED
DATE
I CON4PLETED
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