HomeMy WebLinkAboutBuilding Permit Application (2)SUPPLEMENTAL CONSTRUCTION LIEN LAW i Vl C3RMATON:.
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:
Address: _
City: —.
Zip= Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City.
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie CountV 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 Horne Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Horne 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 its 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 ofd er/Les a/Co ctor as Agent for Owner Signature of C&AractorILWerise 11611der
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF () cA,--h n COUNTY OF 1 iQ�Y a Vl
The for Ding instr Ment was acknowledged before me The forgoing instrument was acknowledged before me
this- day of 20 LI—by this W"day of��..._s 20 1 ` Q by
(Name of person acldnowledgt ) _ (Name of person a snow€ed ing )
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(Signatur of Notary Public -State of Florida
Personally Known OR Produced Identification
Type of Identification Produced
WCHELLfSOMAS
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Commission No.� .�: }"�
N, OMMISSON #FF100795
EXPIRES March 23, 2018
(407) 398-6153 1'IOrldallotaryService.cam
Revised 07/1 I_4
REVIEWS
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INITIALS
FRONT ZONING SUPERVISOR
COUNTER REVIEW I REVIEW
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(Signature of Notary Public -,State of Florida )
Personally Known -OR Produced Identification
Type of Identification Produced
Commission No.
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f407)398-0153
PLANS VEGETATION
REVIEW REVIEW
My COMMISSION #FF100795
EXPIRES March 23, 2018
SEATURTLE I MANGROVE
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