HomeMy WebLinkAboutROWE 2AL CONSTRUCTION LIEN LAW INFORMATION:
DE5I6NER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: i Not Applicable
Name:
Address
City:
Zip; Phone:
MORTGAGE COMPANY: Not Applicable
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Address:
City: State:
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BONDING COMPANY: _Not Applicable
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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 i t li C h
Ms a a ion as 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_
Sire of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA f
COyNTY OF e
The forgoing instrument was acknowledged before me
this day of A�,i"y; ' , 20 15 by
Name of person making statement
Personally Known lr` OR Produced Identification
Typeiof Identification
Produced
ture of Notary Pu iic-..VP 0 F orida) MIKE MARTIN
`t+4, Not ry Public - State of Florld
issian No. _. ; hslon # FF 216951
My Comm. Expires Apr 5, 201
throuph National Notary As
Signa re of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was�acknowledged before me
this -LL. day of
Name of person making statement
Personally Known 1-- OR Produced Identification
Type of Identification
Produced
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re of Notary Pu ick +qf Florida ) MIKE MARTIN
�+� 4 Notary Public - State of Florida
ion Na. + • ° C-gllon #FF 216951
1„�' My Comm. Expires Apr 5, 2019
Bonded through National Notary Assn
VEGETATION I SEA TURTLE IMANGROVE
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