HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTRDN LIEN LAW INFORMATION
DESIGNER/ENGINEER: - Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address: Address:
City: State: City: State:
Zip: Phone: 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 OwnersAssociatiorf rules, bylaws or and covenantsthat may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your-deed for any restrictions which may apply.
In considrtion of the grantingof this requested permit, I do hèr'eby 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 fy11 concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Yo fallureto Record a Notice of Commencement may result in your paying twice for
improvements to your pry perty. A Notice of Commencement must be, re'. rded and posted on the jobsite
before the first inspectiu you intend to obtain financing, consul wi,, - - 'er or an attorney before
commencing work or / or. our Notice ofCommencement.
I
Signature of Ow, wee/Contractor as Agent for Owner
STATE OF FLO?1DT
COUNTY OF \7U....D(Ji( Ut
Sig ontractor/Liçense Holder
STATE OF FLORIDA. R
COUNTY OF (L(L
The frgoing instrument was acknowledged before me
thisO day of , 20 (by
Theforgoing instrument was acknowledged before me
this'\ day of \1\k1X1~JA. ,20 by
(Nam f p son acknowled. g) (Na e oY. erson acknowledgin:
/
(S n- ' • ublic-S at- •
21
ersonally K e0i6ca , on
::.. . 't.'Pu. ic- State of Florida)
Personally Known - :atio
Type, Ident .ii • . em ,. Type of Identific- top JcThR . .
-
ugs 11çr
Commission Ni °'' (Seal)
.ccrnm m.r,2019
Commission No. .'7? -p l0
Revised 07/15/2014
REVIEWS FRONT
COUNTER
ZONING.:
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS