HomeMy WebLinkAboutBUILDING PERMIT APPLICATION (2)-PLZ UPDATE$UPPLEfVIENTALCONSTRUCTION;I
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IEN LAW VIV7INFORMATIQN,
... _ .,_
DESIGNER/ENGINEER: _Not Applicable
MORTGAGE COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone
Clty:, State:
Zip:. Phone:
FEE SIMPLE TITLE HOLDER _Not Applicable
BONDING COMPANY: _NotApplicable
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 InstaIlationhas commenced priorto the issuanceof a permit.
St. Luce Count makesno representation that is granting a permit will authhorizethe permit holde to buildthe subject structure
i which s in contilct with any applicable Home Owners Association rules, bylaws or and covenants tat 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 concurrence 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'resuit in paying twice for
improvements to your property, A Notice of Commencement must be recorded in the public records ofSt;
and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or -an attorne before c encin work or recordin our Notice of Commencement,
$gnafur0l of owner/ Lesse / ontra .torras"Ag .nt for Owner
STATE OF PLO %
COUNTY OFL
Sworn to (or affirmed) and subscribed before me of _� Physical Presence or_ Online Notarization
this 1�.' day of,j_EL l� __, 20,�yby
1 CPJ:�R-D
Name of person making statement,
Personally. Known _ _ OR Produced Identification
Type of Identification Pro
f tAe -D j HOWELL
(Signature of Notar lic- State of Florida i
Commission No, C�G-�g10 g„„ o� S�EMLS D. HOWELL
/ My COMMISSION H GG916931
EXPIRES: September 26,2023
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev 5/20/21