HomeMy WebLinkAboutST LUCIE COUNTY PERMIT APPL1SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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:
BONDING COMPANY: _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 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 attornev before
commencing wort—ox recording vour Notice of Commencement.
Signature of Ownaf/Lessee/Contractor as Agent for Owner I Signature of Conti' ctor/License Holder
STATE OF FLORIDA j 1 STATE OF FLORIDA / / +
COUNTY OF 1.f.2C.�� COUNTY OF 7` t UC.Z'Q
The forgoing instrum nt was acknowledged fore me
this day of G� 20 lby
(Name of
nature of NotaryPfuhlic-1-irate of rinrida
r•
Personally Known , '• uc�d Id�nt�fi
Type of Identification) lit'i5,":lii 01442 ia!
3�
Commission No. r.:itlaijitNoWy
Revised 07/15/2014
The forgoing instrument was acknowledged before me
this day of J-" 20 by
-Vy�
(Name of person si
(Sign
edging
Publi'-§tate of Florida )
Personally Known ed 1dent i�8m�
Type of Identification Pro e = Arnission I GOTOW
xplres: ay
MINI!
Commission No. l4Fl;, mow` L � ru Aaron Nay
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS