HomeMy WebLinkAboutBuilding Permit Application (2)SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
N a m e. Stephen L Somers
MORTGAGE COMPANY: _ Not Applicable
Name: Manuel Duran
Ad d ress: 5521 Spanish River Road Fart Pierce Florida 34951
Address: 5621 Spanish River Road
City: FartPierce State:
Zip: Phone
City: PortSainlLucie State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Add ress: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 your Notice of Commencement.
Rev. 8/2/77
Signatur of O ee/Contractor as Ag nt for Owner
Signatut ctor/License Holder
STATE F FLORI
STATE FLORID
COUNTY Ls r��.3�—��
COUNTY
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged efore me
this (a day of 201hby
this �T— day of 20_1 y
Name of pers�ma�.k,ing statement
Name of person making statement
,
Personally Known L_ \R Produced Identification
Personally Known _,_�oR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
of Nota Pub ic- S Veneziano
(Signature ry FI ��I
{Signature of Notary Public- St ire of Florida )
o��t"'�f
`� NOTARY PUBLIC
�pRyAriana Veneziano
Commission No. " ST(MIPF FLORIDA
Commission No. NOTARY fC
;STATE OF
Comm# GG185914
o FLORIDA
Explrels 211412022
: �. Canm# GG 185914
y Expires 2114120221
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/77