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OESICxNER GINEER; Not Applicable MORTGAGE COMPANY: . Not Applicable
Name;
Address: i Address
City: i State• CityPhone: � : - - S#ate'
Zip:
Zip: _--
Phone:
FEE SIMPLE I TLE HOLDER:
Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address.
City; I City:__
Zip: I Phone: Zip: Phone-
I,I
I certify that n �ork or installation has commenced prior to the Issuance of a permit.
St,Lucie Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con 4t with any applicable Home Owners Association'rules,bylaws or and covenants that may restrict or prohibit such
structure.Pleas consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideratio •9'f the granting of this requested permit,I do hereby agree that I will,In all respects,perform the work
in accordance th the approved plans,the Florida Ouilding Codes and St.Lucie County Amendments,
The following 13111
lding permit applications are exempt from undergoing a full concurrency review:room additions,
accessory strucres,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNINGTI OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
imp overnen i to your property.A Notice of Commence ertt must be recorded and posted on the jobsite
bef e the fi t inspection. If you ntend to obtain financi ,consult wit lender or an a torney before
corn encin ding y r Notice of Cgmmenc • ant.
ILA -1 AX-1
Signa t re of ee Sig a ure o Co tra ce se Hold
STAT' OFF I IPA S�'A E OF. ORIDA
CoU O �� (t COU T OF �C
The forgoing in ument was acknowledged before me The forgoing Instrument was acknowledged before me
thl day o 1. calelme.r 20 bythis qday of 20y
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Name rs acknowledg ) (Name of per n ac nowledgin )
.i
Il nature of No ry Public-State of Florida)
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gnature of ary Public-state of Florida)
Personally Kn ewe Personally Known '
Type of Idem fi PfAduced� Type of ldentifica o � d isRlrvn�ti�
P)otary Public-Stakk@ of Florida
i biic-Sie Florida
commission Na r �M •omrn,Ex�i �iLi 22,2017
,.Commission ptre32,2017 Cprtimissiort#FF 098392 .
.POFf1pe` COMMission# FF 038392
,
Revised 071 . /201.4
REVIEWS INS FRONT ZONING SUPERVISOR PLAVEGETATION SEA TURTLE MANGROVE
ICOUNTER REVIEW REVII W REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS Ii
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