HomeMy WebLinkAboutBuilding Permit Application (2)I
SUPPL'EIVIENTAL CONSTRUCTION LIEN LAW
INFORMATION
DESIGNER/ENGINEER: _
Name:
Not Applicable
PLANS
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
MANGROVE
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
REVIEW
FEE SIMPLE TITLE HOLDER: _
Name:
Address:
City:
Zip: Phone:
Not Applicable
REVIEW
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 County makes no representation that is granting a permit will authorize thepermit 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
commencinfz work or recordin>? vour Notice of Commencement.
_ Signatule oTOwner/ Lessee/,gent
ctor/License Holder
STATE OF FLORIDA STATE OF FL6RIDA
COUNTY OF COUNTY OF S
The forgoing instrum w a cn wledgebefore me
this �ay of 20 j�y
(Name of person acknowledging )
(Signature c
Perso afi Ily Kati Ily K�
Type of I
Commission
ry Public- State of Florida )
Revised 07/15/2014
Pro
keptary Public - siaie or rwnua
ommissi J
My Comm. Extee�sl� ay 27, 2019
nci Ued through quo al Notary Assn.
The forgoing instru
this ay of _
(Name of person
was acknowledged before me
"� 204 7 by
n
:knowledging )
1,6-
ry Public- State of Florida
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• Commission # FF 234730{
My Comm. Expires May 27, 20 e
OF F� Bonded through National Notary Assn
iification
i
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS