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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONCONSTRUCTI©N; INC}11l11TN;EXEN Additional work to be under this — that performed permit check all apply: _Mechanical _ Gas Tank — Gas GPi Shutt — Shutters Windows/Doors WindD — ows— Pond SUPPLEMENTAL`CQNSTRUCTlON IIEN L,ULI lNFt3RMATIt�N� 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: Zip: Phone: Zip: Phone: _ OWNER/ CONTRACTOR AFFIDVIT: 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 representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and 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 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 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 our Notice of Commencement. Signature of Owner/ Less e/Contracto en or wrier Signature of Contractor/License Holder STATE OF KQW&AT)C� ��I STATE OF FLORIDA COUNTY OFT)1 SF�c.�� � l' U44bb(, COUNTY OF Palm Beach orn t , (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of sical Prese ce or Online Notarization 4hs P yslcal Presence or Online Notarization day of 2020 by this day of 202by Damien Agostinelli Scott Berman Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification _ Type of !cleA I ' ation _ Type of Identification Produced Produced nua (Si of Notary Public- State of `,`ea�\ette g'•, (Signature of Notary Public- State of Florida ) 16 1 Commission No. (deal); OTA ,`, Sommission No. (SeqJznzrcosajidx3 f� 9LE901, HH uoissiwwoo /yy n uaIIV ialunH REVIEWS FRONT ZONING �' A •SUfVl�5�jt `3�LANS VEGETATION SE _II nd COUNTER REVIEW '-,, RE. I.EWo' J�, EVIEW REVIEW REVIEW REVIEW DATE Fr�„�,,,�``�• RECEIVED DATE COMPLETED A Oak oft iev.5/6/20 my Pt, Notary Public State of Floriday9 �h Allen Hunter d My Commission H5 106216