HomeMy WebLinkAboutBuilding Permit Application (2)SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERJENGINEER: Not Applicable Pp
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:
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 foffowing 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.
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_ Slgnature Owner/ Lessee/Agent Signature of Con ctor/License Holder
STATE OF FLOR A
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covNTv of .AJC tP COUNTY o� t i
The for instrument was acknowledged before me
this s i day of M 4-i-e—Vt 20 l by
Of
Personally Known K OR Produced identification
Type of Identification Produced
Commission
ANNE 13ROWN WALMACH
Revised U%.E, - 4 EXPIRES Apra 21, 2020
The forgoing instrument was acknowledged before me
this ;L1 day of i/k ,z 20 1 '► by
(Name 9fperson acknowledging) >
(Signature of Notary Public- State of Florida)
Personally Known OR Produced Identification
Type of identification roduced
Commission No.,_}— i (Seal)
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