HomeMy WebLinkAboutBuilding Permit Application (2)SUPPLEMENTAf: CONSTRUCTION LIES# LAWINFORMATION
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable
BONDING COMPANY:
Name: _
Address:
City:
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
Not Applicable
St. Lucie Counter 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 l 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 your Notice of Commencement_
One
_ Signature Owner/ Lessee/Agent
STATE OF fLOR A
COUNTY OF (1C /to
The forgoing instrument was acknowledged before me
this Q day of M 4-i-c-ta 20 -L I by
Of
Personally Known K OR Produced Identification
Type of Identification Produced
Commission
ANNE 13ROWN WALMACH
Revisedd7 d.4 EXPIRES April 21, 2020
s
Signature of Con ctor/License Holder
STATE OF FLOWDA
COUNTY OF _ urle
The forgoing instrument was acknowledged before me
this .1.1 day of ;-,k 20 1 7 by
n/1a - tntil)
(Name gfl?erson acknowledging)
(Signature of NotaryPubllc- State of Florida)
Personally Known OR Produced Identification
Type of Identification roduced
Commission No. (Seal)
MycpM "VVVN WhflALANACH
s3raim . f #0N# FF9aaae.
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