HomeMy WebLinkAboutroyal 2SU�PLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEESIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: 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 pians, 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.
Signature of owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrume t was aclynowledged before me
this � day of �" �- i 20 _6y,
�C c:v'1 � •'7.�
Name of person malting statement
Personally Known ` OR Produced identification
Type'of identification
Produced
The forgoing instrume t was ack owledged before me
this Irday of .r 201 b by
/IC% 0--7 r�
Name of person making statement
Personally Known ✓` OR Produced Identification
Type of Identification
Produced
/ lei
{Signature of Notary Pub c * ��lo ` Igriature of Notary Pub c. .P MINE MARf
FlohMir} Public - State of Florid
� Public State of Florid _
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+ . • am lesion # FF 216951 : Comml slon # FF 216951
Commission No. "�. Expires Apr 5, 201 ommission No. �*�
,', p p 'y� F��;� Y Expires Apr 5. 201
Bonded through National Notary As n. ; ������• Bonded through National Notary As:
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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REVIEW
DA
Rev. 8/2/17