HomeMy WebLinkAboutBuilding Permit Application SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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 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.
s
Signature of Owner/Lessee/Contractor as Agent for er Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Saint Lucie COUNTY OF SaintLucie ��?:::c
The forgoing instpAment wascknowledge before me The forgoing instrument was acknowledged before me
this Way of 20 by this "" day of September 120 by
C.G.Taylor 1 C.G.Taylor
(N person acknowledg' g) ( _01f person acknowl dging
Au�a
(Signature of Notary Public-State of Florida) (Signature of Notary Public-Stat of Florida
Personally Known x OR Prod`\\ gati �>Er'6pyh_ Personally Known x OR Produced Id`�� Eita>Imyj
Type of Identification Produced .• •••,kip �i Type of Identification Produced 1*1.
Commission No. GG oaasoa ��0 /� Commission No. GG 083308 ��pQ? M� ��5 oA,���O���
_* �.� •fir - "S � �'N
y,2 `y��=
Revised 07/15/2014 j�q 0�°''S p00ded�h�����•2� Vo••'y°r qGG 083308 :O�
�blic Undo �q•'d'S pllnded�heA\A
•S A•I \\�� i���AUB•.....• �F REVIEWS FRONT ZONINN�I11111 I dERVISOR PLANS VEGETATION SEA TU /C Tqw�0VE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW 11111EVIEW
DATE
COMPLETE
INITIALS