HomeMy WebLinkAbout2Robert-mcmenamie2-permit-application5UPf t EMElrt t ONSTRUCfIOlk UEN LAW NFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 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
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and p5�ted on the jobsite before the first inspection. If you intend to obtain financing, consult
with Ia ripr nr a att rnpv hpfnrp mmmenrine work or recordine vour Notice of Commencement.
Signa ure of Contra or - or - Of4rier Builder as applicable
STATE OF FLORIDA
COUNTY OF Qr U C 1Q .
Sworn to (or affirmed) and subscribed before me of Zhysical
Presence or _ Online Notarization
this day of MClrch , 20 mod. by
he r+Af e_-)cA-o
Name of person making statement,
Personally Known OR Produced Identification OL
Type of Identification Produced Coal)
-tbo-7b-�z� v
(Signature of Notary Public- State of Florida)
r Zoraido Soto
Commission NOTARYP
STA LO IDA
&
GG315963
1 Expires 3/25/2023
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Rev 10/12/2