HomeMy WebLinkAboutBuilding permit app, pg 2SUPPLEMEN TAL CONST RucT[Or\I LLEN LAw fNFORMATicIN:
DESIGNER/EN GINEER: Not Applicable.MORTGAGE COMPANY: Not Applicable
Name'Name.
Addr ss.Add ress. \ i\
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FEEslMPLETiTLEHOLDng`\iNapplicabieName:BONDING COMPANY\ IN uNo\APplicableName:
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Ci.City.
Zip: Phone:Zip, Phone:
OWNER/ CONTRACTOR AFF IDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
certify that no work or installation has commenced prior to the issuance of a permit.
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n consideration of the granting of this rec|uested permit, I do hereby agree thanaccordancewiththeapprovedplans,theFloridaBuildingCodesandSt.Luciet I will, in all respects, perform the workCountyAmendments.
The following building permit applaccessorystructures,swimmingpications are exempt from undergoing a full concurrency review: room additions,ools,fences,walls,signs,screenroomsandaccessoryusestoanothernon-residential use
WARNING TO OWNER: Your failure to Rec#!p|:::v:efm!:!t:s:t!+!-s#E#gyrieoA::i
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forcrecords of St.ancing,consultment.
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Signature of Co\f€ractor -o# -Owner Builder as applicable
;h';s'u!;d:,#fif,::ti¥?£f, zs,ca, presence or on"ne Notar,zat,on
Name oi person m#king statement.
Personally Known R produced Identification
Type of Identification rodu ed ~
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATERECEIVED
DATECOMPLETED
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