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HomeMy WebLinkAboutLevereault (1).pdfB© I A © A ' ;^ r , i .y 5.I(`i,f r``fy , y:,; , :: : ,...``i,¥„,I.`,`\`,,/,-,``r+,.,,,i,;-/2,`.,,?,:111111111111_ DE'§lG'N`ER7E`N\aliiEER`: \' Not Applicable MORTGAGE COMPANY: Not Applicable Name:Name. Address:Address: City: State:Zip:Phone,A,\,,'1\City: ,1 State:zip:pTone:\,i,,`,``i FEESIMPLETITLE HORE\: H,RTjcab'eName:BONDINGCOMPARjName: ;/ otApplicable , Address: \ V \V\'Address: ` / y ' 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. #LLc.u[cjc:oe:B#a:sy¥Tt!:a:n:¥:aof|Re|Pc;ae.jLe#a:tfao::t#:':s:ir;a:n:t:I:g[!a:#nTfi:,,e%v''[a;#;s:o:r::;n:d:: e0 for ln 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 T0 OWNER: Your failure to Record a Notice of Commencement may result in paying twice for |T:ph::fv:edE#s:tREenger#t:yrjeoAg:,::j8:f%fr::hmemfier:tcFnTsen:t%::ifbyeoLejcn::dneddt;notBteajpnuf?#mmencingworkorrecordingyourNoticeofCommence c records of St.ancing,consultment. \`-\,SignatureofContractor -or -Owner Builder as applicable itAUTNE£FOFFL°RgEL|ijf|/fs :hYs°ife°aryaofffjrmr=:i:!!f|ird,#5C#d i:jE!ibTe °f rfhyslcal presence or online Notarization cki rf\ Lril, \tfitwl Nameofpers-on makingsta ent: Personally Known OR produced Identification Type ofldentific ion pr duced ;;`:5ifiirif^fu;€-:>==-----=:---`--=--=_i--i----i-I-_=i-_=-=--i--±--=±%JOAN"YER REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATERECEIVED DATECOMPLETED evTfJ|T2|-2+