HomeMy WebLinkAboutPFAFF ac permit (2)__I,`-''`\L;€;i`,i`L;a\:\;:{.,?-.,.i.7r}:^`~`-€`,-to.`'.`{;.r>-::^#`%?.``t.i{:,¥`;,+\j~-rJ-..},::`.'t,\,,,,:,'J'`:.,~4i,s:,;€-',...:3'-J=l£-i-.i,`',=';,.:.,;,,-`.;,-I_-.,,-,?:\'.::`,-1't;-'
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DESIGNER/ENGINEER:Not Applicab e
Name:Name:
Address.Address:
City : State :City: State: -
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLD ER: Not Applicab e B0NDING 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.
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ln consideration of the granting of this requested permit,I do hereby agree that I will, in all respects, perform the wol'k
in accordance with the approved plans, the Florida Buildirig Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurreney review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
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our Notice of Commencement.work or recordinwith lender or an attorne before commencin
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Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORI
COUNTY OF
Sworn,io (or and sub ed before me of
thisjsLaavof
hysical Presence or _ Online Notarization
Name of person making
Personally Known OR Produced Identification
Type of Identification Produced
(Signature of Notary Public-State of Florida)
JOANfHAVER
Commgiv#GG282897
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REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED