HomeMy WebLinkAboutBuildiing permit app� � � --4 + y
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: ,Not Applicable
Name: Name.
Address.- Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY. _Not Applicable
Name: Name:
Address: Address:
City: City:
ZAP: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
certify that no work or installation has commenced prior to the issuance of a permit.
St. Lurie Count makes no representation that is granting a permit will authorize the holder to build the subject structure
wh+ch is 'in conflict w+th any applicable Hvme Owners A55ociation rules, bylaws ❑r anpermit
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 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 applications are exempt from undergoing a full concurfency review: room additions,
accessory structures, swimming pools, fences, wails, sins, screen rooms and accessory uses to another bon -residential use
WARNING TO OWNER: Your failure to Retard 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 attorney before commencing work or recording your Notice of Commencement.
C.-Op � /Lo/r�Q r-4� ( 1%,,�
SjgKature of Owners Lessee/Contractor as Agent for Owner
STATE OF FLORID�%_ &
COUNTY OF -1- --.00/
Swor to (or affirmed) an subscribed before me of
this dayofhV� 2 .. by
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Name of person making statement.
Personally Known DR Produced identification
Type of Identification Produced
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(Signature_&FNotary Pu li - state of Florida �
Commission No. (Seal)
Physical Presence or OnIllne Notarizativn
AU D FIE Y 13.11 UMPHR
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev 5/20/f�
MANGROVE
REVIEW
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