HomeMy WebLinkAboutWH APPL 4.13.2017.1SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 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.
Signature of Owner
r as Agent for Owner
STATE OF FLORIDA�
COUNTY OF t ter
The forgoing instru ent was acknowledged before me
this day of r' ` 20 _QI
S� 0 —JA40JO hcr"-
(Name ofXrson acknowle_dgng )
re of NofaVPublic- State of Florida )
Person n OR Produced Identification
Type of140014 atiokglrwkwi
_ My COMMISSION # FF2 �
Commi std
;;?t"IF
21, 2019
Revised 07/15/2014
Signature of Contr4tor/License Holder
STATE OF FLORIDA S
COUNTY OF
The forgoing instrument was acknowledged before me
this day of 20 by
(Name of49dson ackn
re of NotardyPylslic- State of Florida )
Personally wn OR Produced Identification
Type of Id 't&W, n
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Commissi r> MyCO �1K
.. EXPIRES tON # FF233682
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS