HomeMy WebLinkAboutPAGE 2 OF BUILIDNG APPLICATIONSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
N am e: Mellssa K Brooks
MORTGAGE COMPANY: _ Not Applicable
Name: Joe nuran
Address: 110 Banyan Drive Port St Lucie, FI 34952
Address: 110 Banyan Drive
City: Port St Lucie State:
Zip: Phone
City: Part St Lucie State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BOLDING COMPANY: Not Applicable
Name:
Address:im' swsoothMacedoi;w
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.
I
4
Signature 4f O er/ Lessee/Contractor as Agent for Owner
Signature f older
STATE OP,FLO DA
-"
STATE OF
COUNTY O �� �V.��
COUNTY OE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this li day of � � 201', by
this k\ day of 75ft 20_M by
Name of person making statement
Name of person making statement
Personally Known i('R OR Produced Identification
Personally Known CX, OR Produced Identification
Type of Identification
Type of Identification
Pro uced `Zl
6 N_ A), IILMVII� L=&C'
Produced a�
A A A A_ -A-
(Signature of Notary ublitSf�i� veneAano
{Signature of Notary Pub ic- State of F ridaNOTARY
PUBLIC
Ariana Veneziano
Commission No. I �F FLORldA
Commission No. NOTARYPU dealST
Comm# GG 185914
ATE OF FLORIDA
'STComm#
Expires 2/14/2022
GG'I 85914
"
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. $/2/17