HomeMy WebLinkAboutbuilding permit SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DE
SIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
A
9 V a m e:Dean Dekker Name:Manuel Joe Duran
Ad d ress.4915 South Header Canal Road Address: 4915 South Header Canal Road
City: FortPievce State: City: Port5ainlLucie State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:168,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 its in conflict with any applicable Horne 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
com In wor din our Notice of Commencemen .—
Signature o own /Lessee/Contractor as Agent for Owner Signature of=,DA
o der
STATE OF LQRI A STATE OF
COUNTY O i COUNTY OF 7t . 1 C\-Z" °
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of S 20_L1 by this I�day of_ v K� 201 t by
Name of person making statement Name of person making statement
Personally Known C')'- OR Produced Identification Personally Known � OR Produced Identification
Type of Identification Type of Identification
Produced Produced
v l JA A A A A/k A. vav\,A,
�
(Signature of Notary Public-Sta4 of Florida) (Signature of Notary Pu - tatuA iano
Arian Veneziano NOTARY PUBLIC
Commission No. OTAR4 LIC Commission No. TATE 09PWRIDA
liv.
STATE OF FLORIDA Comm#GG185914
Comm#GG185914 ti Expires 21 I4/2022
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