HomeMy WebLinkAboutbuilding permit SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Men B Baker Name:Joe Duran
Address:10851 South Ocean Drive Lot 102Jensen Beach,FL 34957 Address: 10851 South Ocean Drive Lot 102
City. Jensen Beach State: City: Port St Lute State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:1687 SW South Macedo Blvd 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: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
commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signatu(a of ontractor/ ' erase Holder
STATE OF FLORIDA STATEkbF40RIDA
COUNTY OF 7� _ I —JQ _y COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this �day of >� �� 20 \% by this-V90 day of c rC�r� 20 L ay
Name of per making statement Name of person making statement
Personally Known�OR Produced Identification personally Known OR Produced Identification
Type of Identification Type of Identification
Prod ed Produced
{ ignature of Notary VPaAffl a ISO (Signature of u E'aS'a ' gB4idaOTARY LIC NOTARY PUBLIC
Commission No. TATE CFLEWRIDA Commission_ -STATE OF FLORIDNea1)
omm#GG185914 on►m# G185914
r 1g� Expires 2f!4f2a22 s�ti'eE JSJ Expires 2/14/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17