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HomeMy WebLinkAboutBuilding Permit Application (2) SUPPLEII%IENTAL C�ONSTRlCTlONLI�( LA1IV INaRtVIAT[Q [`a E 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: OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. 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 which is in conflict with any applicable Home 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 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 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. rure of 0 er ssee/ gent Signa tu of Contrac r/Lic older STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF 9 , The forgoing instrument w s acknowledged before me The forgoing instrument s acknowledged before me this rL day of20� by this �' day of 20�by (h4ne of person acknowledging) (Na a of person acknowledging) AA IV AA_ (Signature ofNotary Pu Vic-State of Florida) / (Signature of Notary Public-State of Florida) / Personally Known OR Produced Identification Personally Known OR Produced Identification v Type of Identification _ Type of Identification KAREN S. NIELSEN Produced V `��a' I<AREN S. NIELSEN Produced .°`aY P�'% , do`'' °%''- eon mission# FF 115637 Commission# FF 115637 'd •_ M o�mmmission Expires Commission No. - .•` MY( eudi►mi�2;02018ires Commission No. — v� J1 2, 2018 "� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE _ MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW- REVIEW DATE RECEIVED DATE COMPLETED 11ev.7/2014