HomeMy WebLinkAboutBUILDING PERMIT (2) SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: 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 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 our Notice of Commencement.
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Signature of Owner/Lessee/ ntractor as Agent for Owner Signature of Contractor/Li nse Holder
STATE OF FLORIDA STATE OF FLORIDA r
COUNTY OF �� ue, COUNTY OF lu C,
The forgoing instrum nt was acknowledged efore me The fo oing instrument was acknowledged fore me
this�day of M 20 "by this day of /`��� 20 by
(Name of rso ack ledgi (Name of p o kn led
sgr.ature of N "ar u/bRic-State of lorida} ignature of No ublic-State of Florida)
Personally Known OR Produced Identification Personally �`; n �OR Produced Identification
Type _ Type of ld ry Qn rOHNAIMAN RAI-ONO;.TZPATRICK
\V JOHNATHAN RAYMOND FITZPATRICK '_
Com i g MY COMMISSION#FF233RW} Commissi MY COMMISSION#Ff 92
EXPIRES May 21.2019 ' "•.o! EXPIRES May 21.2
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
CO M P LETE
INITIALS