HomeMy WebLinkAbout1808-0005SIUPPLEMENTALCONSTRUCTION LIEN 'LAWJNFORMATION:
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:
1 certify that no work or installation has commenced prior to the issuance of a permit-
ermitSt
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 therantin of requested
g g permit, l do hereby agree that J will, in all respects, perform the work
in accordance with the approved plans, the Florida BuildingCodes 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 tender or an attorney before
commencing work or recording our Notice of Commencement J
i
Signature of Con or/License Holder
_ Signature Owner/ Lessee/Agent
STATE OF FLOR A -
COUNTY OF _ .()c /P
STATE OF FLOQID#J t
COUNTY OF -; !
r
The forgoing instrument eras acknowledged before me
this day of l 20 JIT-by
The forgoing instrument was acknowledged before me
thisZk day S
1
of 20 _Z$_bv
L
(ivame I erson acknowledging)
P {Name of person acknowledging)
(Signature of Notary Public- State of Florida)
(Signature of Notary Pub o Florida)
/`
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification Produced
Type of Identification roduced
Commission
Commission No. (Sea[)
ANNE BROWN W ALIVlACH
=1
EXPIRES Apn7 2i, 21)20
Revised �a6 '
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P'RES n FS 63
REVIEWS
FRONT
ZONING
SUPERVISOR
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PLANS VEGETATION SFS TUrrm—��' ( GROVE 1
COUNTER
REVIEW
REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
I
COMPLETE
INITIALS
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