HomeMy WebLinkAboutPermitDESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
State:
Address:
City: State:
City:
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.
1'certify that no work or'installation has commenced priorto the issuance of a'permit.
St Lucie Counnn��flflyy��makes no representation that is granting a permit will authorize the permit holderto build the subject structure
rict aapply prohibit such
ssttructurenPleasecc nsult wrtt.you Home Ownewrs'Asso iisatlon and review yout deed for any resttrits ctions which may
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
A- Notice Commencement must be recorded. in the public records of St.-
improvements to your property: of
Lucie county and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with nder or an attorney before commencing work or recoMin . our Notice of Commencement.
y
�J
Signature of Owner/ Lessee/ ntractor as Agent for Owner
Signature of Contractor/License Holder .
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF -
Sworn to (or affirmed) and subscribed before me' of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this day off, 2� by
this day of 20_ by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced identification ,I--
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced �1 �_
Produced
2A
(Signature of NoI Public- State of Florida
nature of Notary Public- State of Florida )
Via: P "•�. AUDREY B. HUMPHREY
Commission No. =�W`I S"60MMISSI0N#0G300
Ito mission No. (Seal)
'• �_ SVIRES: Match 6 2023
` ; PA Th- NotariPubUrUild0v
4tQ13
PLANS
VEGETATION
'SEATURTLE
REVIEW
MANGROVE
REVIEW
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.,5/6/20