HomeMy WebLinkAboutBuilding Permit Application (2) SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: - {,
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Robert S Bain Name:Shawn Wolfe
Address:3005 Five Iron Dr Port St Lucie FL Address: 3005 Five Iron Dr
City: Port SaintLude State: City: Palm Beach Gardens State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address:1002 Vision Terr 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 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:roo additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to anothr non-residential use
i
WARNING TO OWNER:Your failure to Record a Notice of Commen ement may result i /your paying twice for
improvements to your property. A Notice of Commencement m st be recorded a posted on the jobsite
before the first inspection. If you intend to obtain financing, colt ult with Tend:r ot,an attorney before
commencing work or recording your Notice of Commenceme I.
; -' „„.46;---L-t-' ►.d 1 A iI j 1
Si nature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/ c-Sre Holder
STATE OF FLORIDA , STATE OF FLORIDA
COUNTY OF • 1-'rA 60'14?y COUNTY OF 6 r. 1.N CAt
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this-!5 day of MAMA ,20 lc by this day of %di( ,20 IC by
MrvrJ- A„t ihZ c..bve4,e,\ ) Sita vJ 4\ ‘..).41-c
Name of person making statement Name of person making statement
Personally Known 7- OR Produced Identification Personally Known OR Produced Identification
Type o Identification Type of Identification p
Produ v d Produced Ynsi', 1 q' d f'� I
/f \ � -
v4 60 A...
UV\ . - -
it'_nature of Notary P. 7,„State SHAWN WOLFS (Signature of Nota;, 1)i estate o-*FJpa�id9FjRIEGI'VENS
_,• ..n ' ” MY COMMISSION#GG 022023
Commission No. ;i ; j MY commissar#FF186835 Commission No �-EXPIRES: �EN� r i8,
of %;e b:; Bonded Thru Notary N',....ii Uaderwiita
' x.015 EXPIRES January 1,2019 ,oF,�„ "P „ �.N-__...
2020
(407)3980153 FloridallotarySerVice.com
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17