HomeMy WebLinkAboutSignature page IERIENONEER.- Not Applical)ld M09PSAGE 1COMPANY. Not Appltrable
Name: Name,,_
Add kidress-
aty" state't city. State,
DO- Phone_____, Zfl) Phone:
f EF,SIMPLE TITLE HOLDER*. _Not Appfic*,1e WNDING iCGMPANY.� Not-Apoficable
DESGN
Name: Name,
Address: Address;
City.: city;
Zip: Phone* Zip: Phone
OWNP,R/CONIUCTOR AFFIMIM.Appflcatfoo is hereby made to obtain a permit to do the work and installation as Indicated.
I certify thatrio work or installation has commenoed prior to the issuance af.a para it.
St.tude Coul make�no riepregentation that Is,granting a lenyxit WD authorize thepermit holder to build the subject structure
Jn� -nd t6vtmapts,that may,restrict or prohibit such
which 4 in can ictwith Owners Assouz tion rules,Waws,or a
A nd Teviewycor dead for any restridrions which May aP91Y.
,ilibable Honu Assod
structure.Please consult t your Home Qwner� . arwii a
In consideratloo.of the grantlilg'of this requested permit,i.ft hereby agree that I will,in all respects,performthe work
in accordance with the kopmved plans,the Norlda BuIfdJ1Jg Codes and St,Lude County Amendments.
The following building permit applications we exempt from undergoing a full CO)Icu'ftency.review;room additions,
accessory simaures,swimming poors,f6mes,walls,Signs,screen rooms anti accessory uses to another non-re5identlal use
WARNING TO UMER:Ybpr fallum tD Record a"Ice of,Commencement may result in You r paying twice for
!MPTOvements to your property.A Notre of Commencement must be recorded and Posted on the jobsite
efore thes4redlon.If you intend to dbtaln fin'ancin&consult w"tender or au afterney before
,.m
"n W
COMM ngw or record' •Ltr motice of Commgnce.rnenl���
Signature of 0vAx6rJ'Ueszs ,fin fSnattkVe Of COntraderfUc s of er
STATE OFIFLORIDA STATE Or-FLOP11DA
COUNTY OF---� COUNTY Or-
-the forgoin evstmrUent was-acknowtedged before me The forgoing instrument was acknowledged before me
ftsa2W_day of by thisaaday of 20-9 by
=_1Sn2ttkr1Qf Clr-tradorltil- 5 of eri�
(Name of persori qcknowladgng) (name of per-sori aftowledging)
—05jjmwk"0y Notary F-Oblic.Stat tfi,iorida)
Personally Known OR Produced Identification Personally Known—4+--OR Produced identification
Type df Wer0catim
Produced Produced
MISE LERAY
Commission No. vjyco fF OF 2commission No,£C•9'16',1my qW"ioh i iE siom
A- 4,
REVIEWS PRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANG-ROVE
IS, ��2.E-7
COUNTER RNtEW . SUPERVISOR
W- REVIEW RVIEW REVIEW REVIEW
DATE
Rga-IVED
DATE
COMPLETED
DNIJO08 IVNIUVO