HomeMy WebLinkAboutBUILDING PERMIT APPLICATION4
,-. .DESIGNER/ENGINEER:.,: '.:. `, K^r'NotApplicable; ,... ItdIORTGAG.E'COMPANY:: .'w'' x• �.NotAppiieable ' , : ', �'.
,Name:' . ' • ' NaF>1e.6, — • r
. :Address: .. . - .. .. .`Address:, • ... - .
City:... State: CitY: State:
:.Phone: gip: _. Phone: --
FEE SIMPLE— TRLE HOLDER: x ' Not-Applicabk BONDING CQMPANY: ' .. ': ' x ' Not Appiica-ble`
Name: � Name'
Address: Address:
City: city:
PhZip_ . Phone:
' I certify that no work or: installation •has comn]enced,prtor to zhe issuance of arm peit: :... .,19
St. tucie County makes no representation that is granting apermit will authorize theerrnit'holdee.fo build3he subject structure'
which is in conftictwith any applicable Nome Owners Association rules; bylaws or and covenants that may restrict or prohlbit'such
•atrUdur .7 Please consult with your Home Owners Associa_tlori and review your deed,for aoy restrictions which may apply. - ` ,
..( +.
In consideration of the granting of this requested` permit, I do hereby agree that I will, in ail respects, perform the work.
in'accordance with the approved plans; the Florida Building codes' and St:, Lucie County Amendments'.
Ti p foiiowing building perThit a.ppiications are exempt f rom undergoing a full concurrency review:, room; additions;
` '!accessory structures, swimming po6is,. fences, walls, and signs; screen rooms ae¢essory uses.to anpther"non-residential use ,
WARNING,TO:OWNER: Your fdilu'�e to Record a-IVotice of Commencement may. result in your=paying twice for ..
irhprovements to.p;' yb'Ur•property'A-Nbtice of`Comrriencernent.rriust-tie'recorded and posted•onthe jo:bsite.;
beforethe first, ins 'ection. If you-intend.to obtain finah6 con'sult.with,lehder or.an attorneY before. '
coinmencih ' in drk-or iecol"din our Notice of C.ornriiencement.
1r _• / �'tial�'i:
tea(- J•:. `+' ..
Signature of Owner/1.rAgent/ Lessee :Signature:of cbntractor•/License Holder ,
!;
STATE OF FLORIDA .. .. : STATE C#t=.FLORIDA
COUNTY OF M�ti�, _ ° .: ; . COUNTY OF,.
The f Instr 'men 'was a knoWle'. dged beforeme '"—The was acknowledged before me '`
#hispy.of �;- z0 4- by.: this �. .day of aearemner 20� by : .
Cty�at Quetiedo 1 : ' ' r = ° ceysfsi Queuddo -
(fVame of p@rsoii acknowledging )—��� (Name of person acknowledging j
iC: ilk! V
, Sry(Signat.arrt8licStatenf flotlda )'
Personally Known OR Produced Identification Personally Known x' 4R Produced identifcation
Type of IdentificationA4'7
pe of Identification. Prod
Comm^1iSS.lOn �Vtl EE,1.1Sr:1, , ni ` ,
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I�ufrt-StatQ'g1,1=1otla r;!mission No.
• = Myr 6gmni,.txpes:,lld 3;; 2� �, : Nbiorla Pubi�r.=;;tgla bt`Flq ,
tM' aonim,leclx►ss;3ul~�i.os�.
Revised'01/15'/2414, •,�• .d Commission if F,E.it ;
f.:
REViE1NS fRONT zON1N�, = SUP7.
ERVaSbR . ' ItAN5- `:' P .VE,GET-ATION -. SEA'TURTtE.:. .MAMGROVE',
COUNTER'' ° REVIEW ',. .REVIEW' . '`REVIEW ' ` REVIEW . !REVIEW REVI
1P. COMPLETE
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