HomeMy WebLinkAboutBuilding Permit Application (2)SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERANGINEER: _ 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:
1 certify that no work or installation has commenced prior to the issuance of a permit-
St.
ermit
St. Lucie County makes no representation that is granting a permit will authorize the rmit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or ang
wicovenants that may restrict or prohibit such
structure. Please consult wdh 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 1 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
Signature of Owner/ Agent/ Lessee
STATE OF FLORIDA C y 1iin
COUNTY OF �l V
The forgoing instrument war acknowledged before me
this �dayof i- R 20 fit
I�ltichQ21 �>o4e,
(Name of person acknowled " g )
(Signature of Notary Pub VState of Florida )
Personally Known i/OR Produced Identification
Type of Identification Produced
�;
..,, CHRISTINE J. CONWELL
Commission q:�'tA ..-ryPublic - A Florida
Commission # GG 017839
Revised
i�
Signature of Contractor/license Holder
STATE OF FLORIDA a
COUNTY OF I�►�
The for oing in ment was acknowledged before me
this�dayof�(y�.20�by " 0_
1 �1
1�11ir, UI � &\Ae.)
(Name of person acknowledging)/
.A S • l l //
(Signature of Notary P�bJ/c- State of Florida )
Personalty ✓/ Known ( OR Produced identification
Type of Ide. t- ration ProdOSed_ _ _ _
�...ua5'tlwr,. 61NNe5AlAl&�.�f[RwEla- L
Commission # GG 017839
Bonded through National Notary
REVIEWS
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ZONING
SUPERVISOR
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MANGROVE
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DATE
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INITIALS