HomeMy WebLinkAboutBuilding Permit Application\a
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SUPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION:
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DESIGN ENGINEER . __ Not A livable
PP MORTGAGE:COMPANY: N ppUcable
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Address
State Cityc State:
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Zip ,. Phone
>' FEE SIMPLE TITLE.H.OLDER: Not Appilcable BONDING -::COMPANY: _Not,Applicable
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OWNER) CONTRACTOR AFFIDVR: Application is hereby made to obtain a permit to,do thework and installation as indicate_ d.
1 oertifyahat no work or,installation has commenced prior to the:issuance of a permit: ,
j�',LucleCoit iauthorize the permit holds ao bulidahe subject sucture
iSin ooi es, bylaws orandcovenants-tint mayrestrict or proftitlt such
ure:_Please consult:w h your Home Owners;Associationand-review yourdeeclfdtany restrictions which may appty.,
in oonsidetation of the granting of this requested,permit a dohereby agree that I Wlll, in ai-I respects, perFomt the work .
in:aorordance with the approved plan;, the Florida Building Cedes,.and St::Lurie County Amendments.
The foilowin builds
B rig permit applications;are exempt from undeigoing a full concurrency re�►tew _room additions;
accessory"'structures, swimmi . rig Pools, fences, walls, signs; Green rooms and acoessoryuses toanother.non=residential use -
''AARNIIYG TOOI!l�NE1G. YOUR> FAIWRE Tp RECORD A NOTICE=.OF COMMENCEMENT MAY RESULT tiN YOUR PAYING`
TIriCE POR `tiMPR01►EMENrS 'hp YOUR PROPERTY; A IYOTKE OF:COMMENCEIIiENT.AtOST 'BE RE�IORDED. AND
POSTED OIII THE JOB SttiE BEFORE T1E FIRST` WECTiiON. IF YOU �IREND TO'OBTAIN FtNANCt911G.170NSULT`
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ER- AiTORNEY'iI;EFORE REGARD N
Sig ature of Oumer/lessee Contractor as / Agenti for Owner 5i
_ ture of Contractor/License: Holder
STATE.,OFFLOiRIDA.:t.i/dFk9RtBl4-
COUNTY OF i�Setn COUNTY OF. T�' ; s
The fo p rig inst " �eni'was acknowletlged 6efoe me The fo ing ins_tru t was a 'knowledged efore me
this ��' tlay of r Vet r 20 :2Dby xhis �a
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Y 20?�tiy
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'Name"of. n malung statement: Name of person makingstatement.
Personally Known; OR Produced>Identification... Personaliy Known
Type of Identification MLIRKANDBEW:BONNEMA Type of IdentrflcaUon MARK 4NO E BONNEMA" '
Y.PUBLIC
Produced : Produced NOT Y_RUBLIC
STATE;OF COLOPA O OF COLORADO
NOTARY ID 90194030034 YIQ 20189039094
" "NOTAR
MYCOMMI 10
tilt COMM ON.E�IRES OCTOBER �� Z022 - � N t7lPIAES OCTOBER 9, Z022 , s
(Signature of Notary Public St4tebf Florida) (Signature of Notary Public- Smote of Florida )
CommtsslonNo %O/g yb394y (Seal)'` ;CommisstonNo 2Q%$�to39a3y '(Seal N
-
REVIEWS._. . r,'FRONT, , ;ZONING; SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
t ;,_ ti . COUNTER REVIEW. $ REVIEW ;REVIEW" F x.REVIEW ` REVIEVII REVIEW'
DATEs s:.,f k
RECEIVED
r �
DATE
COMPLETED
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