HomeMy WebLinkAbout7050 Torrey Pines Application Pg 2 SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER: x 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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated
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 restlict 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 t 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,
accessary 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.
Signature Owner/Lessee/Confi4ttor as Agent for Owner Signatur f Contractor/Licen oldet
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S•Luce COUNTY OF ST ute'e II
The forgoing instr en as acknowledged before me The forgoing inst en Las acknowledge before me
this"day of,L -- 2011 by this, day of 20�by I
Name of personX;;king statement Name of personpoking statement
Personally Known I / OR Produced Identification_ Personally Known ✓ OR Produced Identification
Type of identification Type of Identification
Produced Produced
(Signature of No ry u ic-State of Florida ) (Signature of Not ry P blic-State of Florida)
Commission No. ''�!L'•j"`• &�893UBMRER Commission No. �`�'I"•'` SNELL{5�11}1ETr ,
MY COMRe55i0N r FF OB40E5 MyCQN!WSSnN r rF aa/0f a
cif EXPIRES:APPI 23,2018 ".a a+ EXPIRES:Apnl 23,2018
y, B~Tvu NOV Nb u'+e'anne4 ..4`..la:'• ry Pable Umprwrcwe
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
PATE
COMPLETED
Rev.8/2/17