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HomeMy WebLinkAboutBuilding Permit Application Jul U715OQ:54a Jensen Beach Plumbing 772-225'8779 p1 Jul 0715 09:54a Jensen Beach Plumbing 772-225.6779 p.2 .SPPPLEMENTA CANSTR CT QN LI �t A1N �iNI-QRl1tIATI0N DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _,Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 1 certify that no work or installation has commenced priorto the issuance of a permit. St.Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure which is in conflict with any applicable Horne Owners Association rules,bylaws or and covenants that 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 1 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 your paying twice for improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with tender or an attorney before commencing work or recording our Notice of Commencement. --moi !�-F C. �,. :�.�-.--r...,-... -•yr'� �-"• C__:_.. s _Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Marbn COUNTY OF maw- The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 7 day of 20 by this ?day of J tz 20 Lffby Lonnie Crflbenson" ;} Lonnie Culbartson (Name of person acknowledging:) (Name of person acknowledging) 'r 2'r —A ,gnature Notary Public-State of Florida) ISI ature of No ry Public-State of Florida) Personally Known -OR Produced identification Personally Known P/Olt Produced identification Type of Identification Produced Type of Identification Produced Commission No, Y 1 N is C mmsion o. 972 3 ea F'�597�7 � tt� LYN F WI LSO o!'"'•'•'`, ACLYN F WILS1 N t MY COMMISSION#FF1597 : .E MY COMMISSi©N#FF1 777 ± d'r EXPIRESNoverribsr , 't:aFFd2r` EXPIRES November 8,. 18 Revised 07/35/2014 t407}39A-0l53 PloridaNat2rySenrice.cam (461)398-0153 Fiorldatiotary5ervice•4c REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS