HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION;
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 spaying 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.
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Si ature of Owner/Lessee/Contractor as Agent for Owner Signat e of Contract r/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 54_ k ,a rte, COUNTY OF I ,P
The forgoing instrument was acknowledged before me
this &_q day of 20 Eby
(Name f person acknow i
�r 7�ir�I+• KRISTEN L BENSLEY — # Notary Pubfie - State of Florida
(Signature of Notary Pu
Personally Known R r
Type of identification Produced
Commission No. �`+ 1
Revised 07/15/2014
The forgoing instrument was acknowledged before me
this47 day of Qi Sj 20 � by
(Name of person ac<nowledging )
iT "" '.v,va (Sign'jfure of Notary Public-
Expires MIW f0 20
c ersonally Known s__�
Type of Identification Prod
(Seal) Commission L
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SUPERVISOR
PLANS
VEGETATIO
COUNTER
REVIEW
REVIEW
REVIEW
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DATE
COMPLETE
INITIALS
OR Produced Identification
KRISTEH..L BENSLEY
orida
Al
telrt #�. FF 9704
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