HomeMy WebLinkAboutBuilding Permit Application (2) SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:WILMINGTON SAVING FUND Name:PUBLIO STERLING
Address:8170 MULLIGAN CIRCLE,PORT ST.LUCIE,FL 34986 Address: 201 EAST PINE ST 0730
City: ORLANDO State: City: PORTST.LUCIE State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:5994 NW BAYNARD DRIVE 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 hash mmenced 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 biotite 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 recordigg your Notice of Commencement.
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Signature cif Owner/Lessee/ContraomL&s Ag t for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF o'a COUNTY OF Zu e.i
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this�day of �n 1111 i_L� __� 0If by this day of�J�t rt vn r�i .2C��by
3' "
Name of person making stateme6F blame of person making stateme
Personally Known OR Produced Identification F p L Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced -FL .D Z Produced fL L—
o� r G l
(Signatur of Notar f�:lo:icia.A�. (Signature of No - Florida)
DO'�R�IS,❑0186 :jC'•�'h s DORIj�q0�a
Commission No. COMII/i5 Q p FF205465 Commission No. OMMISSIDNA F205465 I
e: EXPOS March 17,2019 •��!6 .•` EXPIRES March 17,2019
114C.f.1 3904'b3 Few arySw.vice. i +�I,"'",rA'b3 Fkwds
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
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