HomeMy WebLinkAboutBuilding Permit Application (2)SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name-,
Address:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: ` Not Applicable
13ONDING 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 thepermit 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,
accessary 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 far
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
commencine work or recording your Notice of Commencement. -�
_ Sign re of ner/ Lessee/Agent
rise Holder
STATE OF FLORIDASTATE OFLORIDAF
COUNTY OF -3 _ _u c, COUNTY OF S'"i
The forgoing instrument was acknowledged before me
this day of _ 20 --by
(Name of person acknowledging)
—k��
ignature of Notary Public- of Florida j
Personally Known ✓ OR Produced identification
Type of Identification Produced - __
The forgoing instrument was acknowledged before me
this day of
20 by
C° CSS ll
(Name of person acknowledging)
(SEgnature of Notary Public- Stat orida j
Personally Known V, OR Produced Identification
Type of identification Produced
�R RINti ATHER RING
Commission No, Commission No. hiivfl55[ON!{FF144529
a SSION # FFI40529
ox�cF EXPIRES: July M 2020 EXPlk135: 3uty 10, 2620
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS