HomeMy WebLinkAboutBuilding Permit Application (2)SUPPLEMENTAL 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:
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 holderto 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
commdncine work or recording vour Notice of Commencement_
91z w
Sign at�, re of 0 er/ Lessee/Contractor as Agent for Owner
(f
Sign of Coor/License Holder
/
C/
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF--
COUNTY OF -1—
The forgoijg instrum nt was acknowledged before me
%
The oing instrument was acknowledged before me
Nday -7e b
this t9�y of 20 by
this of 2018 by
Gary W_ zaneiro
Gary W_ Zanello
name of person making statement
Name of person making statement
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
'type of Identification
Type of ldentification
Produced
Produced
Danielle
.4WXA>� �'; :p�l�-,, Danielle Biglin
„� �`�. ftlin
(Signature of Notary _d`bli t�of Flr� Aegust25.2019
(Signature of Notaryublic 3 at � Ida )MMMISSION fFF901M
- EXPIRES: August 25, 2019
�
Commission No_ Fr90t4099 �4 � � (Sd W.AARONNOTARY.COM
%., www.AARONNOTARY.COM
Commission No. FF901099 'I/Fi111\\\\ C
(.7ea I )
!i 1115\\1
.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. 612117