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HomeMy WebLinkAboutBuilding Permit Application PAGE 04
SEACOAST SHEET METAL �
08/11/2015 10:17 7724662417
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;08/11/2015 10;17 7724662417
SEACOAST SHEET METAL PAGE 05
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DESIGNER ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name: '-
Address: Address:
City: State: City: State:_
Zip: Phone. Zip: Phone:
FEE SIMPLE TiTLE HOi,DER., �Not Applicable BONDING COMPANY: __Not Applicable
Name: Name:
Address: Address:
City; City:
Zip: Phone: Zip:_ Phone:
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
W is in conflict with any applicable Nome owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Nome 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 concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING To O HER:Your failure fits Record a Notice of Commencement ma esult in your paying twice for
improvements o your propFnyig
y.A Notice of Commencement must be re ded and pasted on the jobsite
before the fir inspection. ) ou intend to obtain financing,consult wit ender or an ttorney before
commencin w rk or reconou Notice of Commencement. A Ji
� s
Signat of owner/Les elAgent Signature of ontractor/Licens older
STA OF FLORIDA STATE F FLORIDA
CO TY OFarLu COUNTY OFszzuclE
The raving insJrhyknowledg efore me The forgoing instrument was acknowledg ore me
this day of ZO by this " day of Auausr 20 by
JOHN V LAN JOWN V LANGEL
{N of person ack ledging) (Name of per c now(edging
SSigna :n)tification
{Signature of Nat y P blit-State of rich Person Known x OR Produced IdPersonally K x OR Produced Identification
Type of identification Produced Type of ide if ro
I KAY
commiss n�`n*'4 commissio NID'v J Myc TRAOY� N �4 '07a
EXPIRES Au
MY GOMMISSi©N#FF1a807a, too?) 5A 0 $ut§f 3p,2018
EXPIRES August 30,2016 �lca,oam
�ZEViSe rsta�i�rl A FloridaNat� S®rvlcQ.cam
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE _
INITIALS