HomeMy WebLinkAboutBuilding Permit Application Apr 191701:45o First Choice Plumbing 7728797860 p.1
Apr 19 17 01:47p First Choice Plumbing 7728797860 p.2
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY, _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: hone:
FEE SIMPLE TITLEHOLDER: T Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: hone:
I certify that no work or installation has commenced prior to the issuance of a permit
5t.Lucie Counter makes no representation that is granting a permit will authorize the per it holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and cc venants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed forany 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 concurren review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory usesto another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement rr ay result in your paying twice for
improvements to your property.A Notice of Commencement must be rec orded 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.
1 s
IASilaur-e of Ow a Contractor as Agent for Owner UTE
ture o ntrar/License der
TE OF FLORIDA OF FLOFtgA
COUNTYOF -S+ Uci COUNTY OF i
The forgoing instrument was acknowledged before me The forgoing instrum 2nt was acknowledged before me
this Iq day of Atrc�1 20 ]1by this JCII day of1 20 ]�by
_ap���
(Name of person acknowledging) (Name of person ack iowledging'Vvc�_'31LIA' IVI\-q }
k1_2 I-A('11
PI W .
(Signature of Notary Public-State of Florida} (Signature of Notary Public-State of Florida)
Personally Known , -,-'OR Produced Identification Personally Known OR Produced Identification
Type of Identification roduced Type of Identif icatioi i Produced
Commission No.FFg51CVAk0 (seal) Commission Noff 51014 t0 (Seal)
%NOTARY PUBLIC-STATE OF FLORIDA NOTA14Y PUBLIC-STA:CIFORIDA
Revised 07!1512014
d3 C0mm.*FF 957046 4,�a .�� COMM.M FF
MY
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGE 17ATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW RE IEW REVIEW REVIEW
DATEi
COMPLETE
INITIALS