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AUG-21-2015 FRI 12; 51 PM CENTRAL SCHEDULING FAX No. 3212686138 P. 003
s. ,; � d �"' gra ..s� GY, yi •� �. r .N —
DESIGNI:RjENGINE)�Et: r Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
-
Zip: Phone, Zip: _-_--Phone:
FEE SIMPLL TITLEHOLDER: !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 priorto 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 is In conflict with any applicable Home owners Association rules,bylaws or and covenants that may restrict or pro lbit 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,l do hereby agree that I wiil,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 fuli 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 lender or an attorney before
commencing work or recording our Notice of Commencement.
Sign urea caner/Agent/Lessee Signature of on,, ctor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF _
COUNTYOF
The f fling hist er t as acknowledged before me The fo.g Ing instr ent was owledggdd before me
this .day of -K 20 by this Sday of 2-
616 by
t> Ar � .
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public*state of Ofida} (Signature of Notary
yPublic-State of F da)
,Personally Known h OR Produced Identification Personally Known 1 OR Produced identification
Type of Identification Produced _'ANR ,,,, � Type of Identification Produced
i l 1 :�• GQ4tAilSSl4Il#IS i�3 � —y r�� . �8therine xq.A,�fri
Commission No �• +,�: ommission Na� �-r� r.�...� lonfr 172372
karplres:OCT 2B,2p
$ONDExpires:OCT 28,2016
LDA
IST FLOR
i A N 'lA�g Uk •�' 1 DONDEDTHPU
Revised 07/15/2014
REVII WS FRONT ZONING SUPERVISOR PLANS VEGETATION 5FATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS