HomeMy WebLinkAboutSIGNATURE PAGEDESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:
Name:
Address:.
Address:
State
City:
State:._
City:.
Zip: Phone:.
Zip:... Phone:
FE{ SIMPLE TITLE HOLDER:
_ Not Applicable.
BONDING COMPANY! _Not Applicable
Name:
__
.Name:.
Address;
Address:
City:
City:
_
Zip: Phone:
Zip: _Phone;.
I cernFl that no work or installation has commenced prior to the Issuance ore permit
St lube County makes no reprepentabvn that fr grant ng a Permit wdl authodtethe�tarM>nfroldehti.�mav� esciu:[dot orohlbit su<h
In consideration: of the granting of this requested permit, I do hereby agree that I will, In all respects, pecawho the work
in accordance with the appowed plans, the Florida Building Codes and St Lucie County Amendments.
The following building permit applications ate e.empt from undergoing a full Wncurrency 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 COmmentamentMay result In your paying twice for
Improvements to your property. A Notice of Commencement must he 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.
(� 5
�Signat ,oar LasseeTConiractor asAgont for Owner g�grgture +Vactorfucense Holder ;
� STATE OF FLORID STATE OF FLORIDA -14,? f
COUNTY OF s% c- COUNTY OF.
The QQ�Mi+�stru askn edge{Lbefore me The f-or��yf�ng rostrum t kno ledge/d before me
this (fiaV: of �FiAJ1 20 j�,bY this Vinay iA �30 L-_-bY
r6TtaCl Cir rW�
I (Name of sbn acknowledging) {Name ofPersianacknowledging l
i
(Signature of Notary Public- State of Florida)
(Signature of Notary Pubhcc State of Flonda ).
Personally Known OR Produced Identification Personally Known OR Produced Identification.
Type of ldentificatwn roduced Ty eofl an ifi t
�. ELIZsgETN EVWg )
Commfsstop! 4.. ' o u�1 Y���� data d
cnmmissim t FF 989112
- . ....._
Gammissbn t R 9H142 ^
ERIVAIE�WS FRONT ZONING..COUNTER REVIEW REVIEW - REVIEW REVIEW REVIEW REVIEW
E