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Stilt_ .r'- „5'L��L re,",r[•:rk.? w- 1'"�';�-L1.'...J•.:.s.:.�,r-:__.:c�'�-I�c:f::jz,� �`1�..._.e.,s„�.,�.�xi.c.�r.<di::i<:�•e2•._,�....,�-.:.a,. WON ZL— • •.•' 33A �` Y Phone .• ! • ••- • f WNWO Fill.in fee simpleTitle Holder an next page(if difft-went from the.t -, above) • • NOV/30/2021/TUE 01 ; 40 PM FAX No, P, 002 iJESIGPi.LR/tNGINEEKi M4010bler MORTGAGE COMPANY,, Not Applicable Nerve: Name: Address- Address: City: __.___-_State. City State: Zip: phone dip: Phone' FEE SIMPLE THE HOLDER. Not Applicable 130NOING COMPANY: 6t,Applicable Name. 74 Name: .A�iclr'e�s; _ AddYEss.: . Ci : City: Zip: Phone: zip: Phone.• _ OWNERI CdNTRACTOR AFFIDVIT:Application is heteby Made to obtain a permit to do the work and.}nstallatlon as indicated. I certify that no work.ar instal lation has commenced prior to ibe issuance of a permit. St,Lucie County makes no reepresentation that is granting a permit wilt authorize the permit holder to build the subject str- ctuiv which is in confUct vwitb art .•applii able Koxrie pwi; 6 Assacratrnrt rules,byllws.or and covenants that may rastda or prohibit such structure.Please carFsuitw�tl�yo.g flame owners�sgeiatlon and review y-bur.deed fo.r any restricelons which mayspply. In GorlslQ.ration r?f the�gra'r7Fing of this requ%ted permit,I do hereby agree that I-wit1,Jrt.all respect.,perforo the work in accordanvewhi the apjirowed plaris,the Florida Building Codes and'St.Lucie County.Amendments. 'Tire following building 0whit Rpplic*1ons are exr rn.ptfroffi undergping a fad[toncurrency review:room addifions, acCesSoi ystructure5r sw&Irving,pools,fence.,vyaiis,signs,screen roomy anri accessory usesto another notl-residerrtfal use 11ii'ARir19NG TO OWNER'.Your failure to RaGard a-Notre of Corn mencoment may result in paying twice for improve rr►enfis to your property_R Notice of Cor><�rimencemant=murst.•be recorded in the p''ubiic records of St. Lucie County and posted on the jabryrte beffare the fjrst inspeotlon-if yqut intend to dbtwn fina�ncirtg,consult with lohder or-an a t�rne before•c6mrrlencin work'or recc�rdtn.g your Notice of Cgrnmancement. Si atftre o� 1tesseef Contractor as Agent for owner ature-of Col7trattor/Cleanse Helder STATE OF FLORIDA- STATE OF FLORIDA C.6UNTY OF "Z> -C I)CA G COUNTY 4f 'At�d Sw to(or affirmed)and subscribed before me-of Sw rn to(or affirmed)and subscribed before me of P sica1 Prese ❑ Crnllne-NGrarizatlon V Physical presence or online Notarixazion this' day of 2t}2© by th7s day of,�6�/�iYV11�JPJ1�..2A2i1 by 1�4ameof.pers6nnn•kingvtabanlent_ Na.meofpersonrrlamn7ORProduCedidentificaticin- Type lrm rit. y PersonalE Known OR Produced identification� PersonailyKnov�n of ltientI 6 tion Type of Identification Produeed Ur Produced Pgnatgm of No ry Public-5 ate bf Horida). (Signature-of Nota u lit-State of F r ry publics larlcs f Kenna Lyn Gab' Co 171 i � � alb Commission Nofl_q_D ? 1MWE y ComrnhWon H a91 6 xFires 1rm2w=. *; ., Commission HH ;Ft2VIzjW SUPERVIS911 PLANS VEGETATION SEATLIRTLE MAMGROVECOULTER REVIEW REVIEW Rl_1/1.EV1/ RE-VIEW REVIEW DATE RECOVED DATE CGMPLM- D ev. .