HomeMy WebLinkAboutBuilding Permit Application (2)-SIJPPLEMENTAC CONSTRUCTION LIEN LAW'INFORMATION:
DESIGNERIENGINEER: — 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:
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 dome Owners Association rules, bylaws or and covenants that may restrict or
Please
structure. prohibit such
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 our Notice of Commencement.
s
_ Signature Owner/ Lessee/Agent Signature of Conctor/License Holder
STATE OF FLOR A STATE OF FLO
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COUNTY OFCOUNTY OF /
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Q day M r4-,c_ti
of 20 - lby this ;W day of tis 4 � e_l. 20 i 'i by
n oe 1-91-6 �A
(Name of person acknowledging) (Name erson acknowledging)
anll
(Signature of Notary Public Stat a Florida } (Signature of Notary Public- State of Florida }
Personally Known OR Produced Identification Personally Known. OR Produced Identification
Type of identification Produced Type of identification Produced
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Commission.- r --_ted Commission No. �� �`�, (Seal)
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;g• ANNE 13ROWN wALMACH
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EXPIRES April 21.2020 '' My CO N WAtIVI C
Revised 7; 4 ��•,,, MMISSI A H
FtatdaN�9rySeryjp,edn ,.
EXPIRES �1M # FFgE4683
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA GROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALSL
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