HomeMy WebLinkAboutBuilding Permit Application (2)SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: xx Not Applicable
Name:
MORTGAGE COMPANY: xx Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: xx Not Applicable
Name:
BONDING COMPANY: xx 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 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,
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. r
A c M
Signature of Owner/ Less e Agent
STATE OF FLORIDA j
COUNTY OF &. �.,d,1 d e—
The for ng instrument was acknowledged before me
thisc ay of Unri 20 L.'Ll by
UJ;//1-3m �1 • �36 ffni 4"fr
(Name of person acknowledging )�
biro CCCfff�c.✓�� d
(Sikdature of Notary Public- State of Florida )
Personally Known VOR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
Signature -of Contractor
STATE OF FLORIDA
COUNTY OF S1. Lucie
The for of g instru ent was acknowledged before me
thisay of 20 by
Wanda Gahn
(Name of person acknowledging
(Inature of Notary Public- State of Florida )
Personally Known `� OR Produced Identification
Type of Identification Produced
KARRA Pamom Commission No.
NOTARY PUBLIC
Coram# GG090836
Expires 4/23/2021
Kristine� ons
N0TAR E'U6UC
STATE OF FLORIDA
Expires 412312021
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