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HomeMy WebLinkAboutOntario (1)©# a ¢ DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: / _Name: AiiddrF:ss.. ir` I [\Address:city: r // frT state:City: State: zip: ph9Ae I J Zip: Phone: FEE SIMPLE T lTLE HOLDER: Not Applicable B0NDING COMPANY: Not Applicable Name: / A Name: Address: I_ / /\Address: cit. /\ /Cit.7J,p;. -rhiKyf,.. AI Zip: Phone: OWNER/ CONTRACTOR AFF lDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commence.d prior to the issuance of a permit. #irccutcu:;oe#:ia:sy¥¥t!:a:#a°£|#eLPc;aeo5Le#agtfa°:gtfit:[[S§%r§asngt:|3g!iag!e:LnTg'Sr,ewB'}[a;#;s:o:r::;n:d::8f¥P:en:a#:t§t':d::a:##[d[##Pa8:hcbtpyitt:uuccthure 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 concurrency review: room additions, accessory structures, swimming 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 resul t in paying twice for [TcP:ocv:umn:,tasntdo#tregr:#:[teyj.oAbFj::j8%fr::hmemfjer:tcFnT;en:t%::¢fbyeoLejcn::dneddt:notEteajpnufpLj c records of Stancing,consult with lender or an attorney before commencing work or recording your Notice of Commencement. t';_ (( i , a, \l~ffi ,i- Signature of Conturcror -or -Owner Builder as applicable SbAUTNE£FOFFL°R]D|dst, I uO `C :hTsoffdoaryaofff,r.;§]Sg]f€±;;±\bffied fg:{a[ebTe of _rfhys,ca, presence or on,,ne Notar,zat,on Name of person making statement. Personally Known OR oduced Identification Type ofldentification prod ed `..--;:;-i,`t.` JOAN "AVERi:;fa¥@:£#=£=j£ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TU RTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATERECEIVED DATECOMPLETED e!NTJJITZ.I-£|