HomeMy WebLinkAboutBuilding permit app pg 2SUPPLEMENTAL CONSl'RUCTIONt.lBll·IAWINfORMATION::. ·. . . .
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DESIGNER/ENGINEfR: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
Qty: State: --Crty: 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 AFADVIT: 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.
St. Lucie County makes no ~talion that is granting a pel1!lit will authorize the permit holder to build the subi<1q structure
which conflicts with any apJ>!iCable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your HomeowRefS Association and n!Yl1!W 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 e,oempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, saeen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice afConmiei .... ement •"'"Y resultln 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
ith le d befo . rk d. of Co w . n er or an attomev re commenane: wo or recor tnlZ vnur Notice mmencement.
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Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA St~ COUNTYOF
Sworn to (or affi~ and subscribed before me of ✓ Physical Presence or __ Online Notafization
thislOk. day of I.La~ . 20~by
Ml~eJperson~ak~i!.-t
Personally Known ✓ OR Produced Identification --Type of Identification Produced
('7 J,1, ;if;.,;, () I ~--~ .
(Signature of N-ry Publi,V tate of Florida)
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Commission No. .,.,, .. ·,, . CSlllslJIHE JOYCE CONWELL
t.; • J N0t1ry Publtc • Stitt of Flortd1
1t1 CommlHlon # GG 91 ◄701
• , ............ / My Comm. Expirtt Auf ll, lOl;
londld throu,tl Nollon1t N011ry __
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURllE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED ... ev _, __ , __