HomeMy WebLinkAboutBuilding Permit Application (2)SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY- _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenaritr 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.
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S gnatur Owner Agent/ L se
STATE OF FLORID
COUNTY OF WL LrJ
The forrggoing instrume was acknowledged beforer me
this l day of �Qi�_ 20 by `?f
V i Ju 01
(Name of person acknowledging)
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(Signature of Notarylic- State of Florida )
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Personally Known V OR Produced Identification _
Type of Identification Produced
•••�., CHNISTPt QONWELL
Commission No -ca".', e,`'• t�,,
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S.L• A �. Commission d GG 017939
Revised 0711 Bonded Mmol, ^ialional Notary Assn.
Signature of Contractor/License Holder
STATE OF FLORIDAf , I /1
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COUNTY OF Ltk
The fP mg inst mens was acknowledged before me
thisL ay of wr> s��f � 20_, b
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(Name of person acknowledging
&V've -
(Signature of NotaryPu ' - e of Florida )
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Personalty KnR Produced Identification
Type of Identification Produced
Commission
IISTINE J.
Public • S
My Comm. Empires Aug 21, 2020
Bondedthrough National Notary Assn,
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