HomeMy WebLinkAboutBuilding Permit Application (2)SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: .
DESIGNER ENGINEER:_
____,Not Applicable
Name:
MORTGAGE COMPANY;
Address:
Name: .� Not Applicable
City:
Address:
Zip:phone State:
,City:
Zip: Phone: Stale:
FEE SIMPLE TITLE HOLDER: Not Applicable
Address:
BONDING COMPANY: ; Not Applicable
Name: ---
City:—
Address:
Zip: phone:
city:—
zip: Plaon
OWNER/ CONTRACTOR AFFIDVIT; Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no worts or installation has commenced prior to the issuance of a permit.
w Lucie County, makes no representation that is granting a permit will authorize the permit holder to build the subject structu
which is €n conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit s
structure, Please consult with your Home Owners Association and review your deed far any restrictions which may apply -
In
€ re
In consideration of the granting of this requested permit, l do hereby agree that I will, in all respects, uch
in accordance with the approved plans, the Florida Building Codes and St, Lucie County Amendments. Y PP Y
P , perform the work
The following building permit applications are exempt from undergoing a full concurrency
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessary ses to another non-rereview: room sidential dential use
WARNING TO OWNER; Your failure to Record a Notice of Cornmencernent may result in Your
improvements to your property. A Notice of Commencement must be recorded and poster! on th
before the first inspection. if you intend to obtain financing, consult with lender or an attorney b twice for
commencing wo r recordin our Notice of Commencement. a jobslte
Y before
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF z czz r2
The for ping 3nstru�}� t as cknowledged efore me
this ' day of MAX 213by
1 10013 /
Name of person rr Aing statement
Personally Known ._✓ flB Produced Identification
Type of Identificafiron
Produced Erik i�e131flga
�COMMINIon #
Gi014
B+�nresded �MayrFa�20Z1
(Signature of Notary public- State of l lNot
orida ?
Commission No, (Seal)
REVIEWS FRONT ZONING
SUPERVISOR ORCOUNTER REVIEW VIEWlATr
DATE
COMPLETED
Rev_ $/2/27
Signature of
Holder
STATE OF FLORIDA
COUNTYOF g
The fog ing instru t was acknowledged OZfore me
this clay of ZO e!�J ley
Name of person makin atement
Personally Known C..Produced Identification
Type of Identification
Produced- ,tpljr
Comtisslon �' GG
Bras: May 4
(Signature of Notary Public- State of Florida ) Bended th
Commission No.
(Seal)
:REVIEWIANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW