HomeMy WebLinkAboutAcknowlegment To NotorizedA. 'l-AM.THE.O.WNER,O]F-.RECORD QF.'TIIEA13OVE.DE CRIBED:
PROPERTY AND VILLBE CONDUCTINGTHE WORK AS'OW.NEWBUILDER..
.Dlsolosure-qatemel7t.,,Sta'telawtequiresconsbv&onto,be done bylkerisadcontradors. You have-app6dftaperwItander
ane;d#mp.ffonto:o,ktl,iot-7.hegkL-inptI 0-cvdgln ..0)74/ - . ,ffiaet 'urq0Ppqn#actqr.v
rest&Wfis even though.you do,70t have a A&w.. You aiya �, ftitb i�of W�bq. of the combvitto
=Lide.dik . , _#
You may bqlld :or improve a one*&Ily -or--6vv-6fni1y or -a farm ouffidlIding. You may -also bulld or,improve a
cbnV?itirlal.bulldlng,PtoW&-dyour dtg&- o.not &&, ed $75000, The bdIld1no-or ikVdg1w_- most be for ybvr own .Lae or
wwwrIcy. It May hot -be &W orsubstawally improved for sale or•lease. lf'YW:sellortem.,7bL#Iifngwtl.haw.bulltor
pb*idly impioVedy0iltm1fwittily
svbst,an�al�improveditforsale.orl.vse,,-whlahl-�a violation.of thls-ewm*on, -Yoty.-may-nothlfean-iinllaysL-dpwon load'"
or su _pgrv.
ft, kO
:by requl -and �r to .you have.11cetwes- fed bysMk. Aiw. y MW!dpal llcensft or0nan.ws. You: may t - the
to ,peffbim the "a* ew Ybtw1w.WAnk person
.,#by.
y
'Mat emp � low, al/ as
bvjld/py..cedes, and-Vnk.9 Mons:
A D
DESCRIBED PROPERTY; HOW.E-VER-,I HAVE AUTHORITY T.O.ACT AS.AGENT
FOR THE OWNER 01; RE ORD, fSt. Loot Coidity Cdde i7nd ip9m piledLiMs-nZq * 0'
ihat, this. ope oftork be done by a licensed coalractor.• PLEASE PROVIDE
.DOCUMENTATION).
*ST#TE OF FWRIDA-t.
COUNTY OF ST.-LUCIE
The flortgoing. ins - -men w, k -01,Vledgtd
ne ti, d 20&
before 'tj S Of
by -MV] 9w Ep, Who IS
perso6qjWdehow to me or has produced
4 - . as identiripadoi.y.
Signkure-of Notary.
Type
T0-Pri.. nt• w-0171 nqrj -
Notary-Ablic- Title
tiffibo
Notary Public state of Florida
Frances Donza
My commission GG 092440
4,Xof Expires 0712712021
APPLIPATION I$' TRUE.- AND
�--,ONTR�CTOR SIGNATURE
STATIE-OFTLJORIDA,
COUNTY OFST. LUCIE
'the foregoing: insttomentwas acknowledged
before me'this day oft, 20-117
by. .9 ; who,is
peponall . wt0meorhqs.proqqq0 as identification.
'gigna`f& ofNotary
Type Or Pdnt Naine of Notary
Not" Public
W, Qw, �
APPROVED'.— DENIED
—
REV1FW0/APPjtQVMl§ _-
Y -
ENVIRONMENTAL RESOURCES DEPARTMENT DATE'
- Tide
Commission Number
JAMESROUAN
My COMMISSION # GG 008627
EXPIRES: November4,2020
Bonded Thru Notary Public Underwriters
UPDATED ViO 14
S.UPPLEMENTA-C6NSTRUG `tdN O"RIVtAT1ON:
DESIGNER ENGINEER: _ Not Applicable
Name:
MORTGAGE. COMPANY: Not Applicable
—
Address:
Name:
City: ° State:
Zip:, Phone:
.Address:
City: _ State•
Zip: —"
Phone:
FEE SI1011LEIITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicatile-
Address• -
Name: . .
Address:
City. _
:
Zip: Phone:
Zip; Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
- wwn� manC {.IV. Wre er I lion trial is granting a pel'mit uyilt autporize the ermit holder -to build thesub�ect st�rruu��cture
which is in:con ict wl any pp ca a Home 0ytr ers Assoc�at on rotes, by aws r.an��coyenants that may restrio r prohibit such
structure. Please consult w t�i your Home'OwnersAssodation and review your r�eed:for any restrlcttons which may apply.
In consideration of the granting of this requeste&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 eXdm'pt:from. uride►going a: full concurrency review: room additions,
accessory structures, swimming:pools,.fences, walisr signs, screen rooms and accessory uses ta•another non-residential use.
WARNING To OWNER: Your fallure"to Record a Notice of CorriMencerrient may result In our
'Im rovements to our roe Y Y paying ttNice for
p Y property. rty. A Notice Commencement must be recorded and posted on the jobsite
before the first inspection. if you intend to obtain.financinp, consult with lender or an attorneybefore
CATnR1Pnf lno-funr4 rir rd'rwrNiw........�'wi.���_ _t i•._, _- -.- .- -. _ _. .. .
COUNTY
The fo�rdQ Ing-instal Y acknowledged before me
thisC'''day of % � 20
J
(Na . of • n.acknowledging )
(Signature of Notaru Public-S ate of da )
Personally Known \y' OR Produced Identification
Type of Identification q
Commission No.
Revised 07/15/2014
Notary Public State of Floddi
FrangUilpnze
My Commtseion GG 092440
Expires 07r2712021
5
Signature of CZRIDA
ctor/license, older
STATE'OF F
COUNTY OF� 57- `t(A
The for acknowledged before,me
this day of CC yLh 20 j._�L by
(Signat � of Notary Pub to of Florida )
Persa Ily Known OR Produced Identification
Type o Identification Produced
MY COMMISSION # GG 008627
Bonded Thru Notary Public Underwriters
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