HomeMy WebLinkAboutBruyere AC Change out permit app pg 2.pdfSUPPLEMENTAL CONSTRUCTION UEN I.AW fNfORMATION: .
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DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: -Not Applicable
Name: Name:
Address: Address:
City: State: --Qty: State: --Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFJDVIT: Application is hereby made to obtain a permit to do the -and installation as indicated.
I certify that no won: or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no ~tation that is granting a permit will authorize the permit holder to build the su~ structure
which conflicts with any aPJJ!icabte Homeowners Association rules, bylaws or and covenants that fl)3Y restrict or prohibit such
structure. Please consult with your Homeowners Association and re,new your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that l will, in all respects. perform the work
in accordanO! with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are -,pt from unde.gulr,g a full <:oncunem:y rev-: room additions,
accessory structures. swimming pools, fences, waits, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Recocd • Natic:e of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the pubffc 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 attorney before commencinl! work or recordinl! vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA ~L_ J ,,,.;,,
COUNIYOF ____ Jr __ ~-~------
%hysical Presence or __ Online Notarization Swom_toJor affirmed) and subscribed before me of
this~yot t½N1mt,ec .201:!_by
HvJ,,,e1 E. Bo~
Name of person mail<ing
Personally Known ✓ OR Produced Identification __
Type of Identification Produced~---------~ a. &-uwLLL
(Signature of Notary tft,iir:-· _
f#.'~ ..... \ CMRISTINE JOYCE COHWEU
Commission No. · )Not.ry PtJollc. swot F/onu \. f/ M Comminlon, G<i 944701 •• ......... Y Comm. ExpirtsAu121 2024
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Bondld throu1h N1tion1/ Notll)' ,_,,_
FRONT ZONING SUPERVISOR PIANS VEGETATION SEA TURTlE MANGROVE
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