HomeMy WebLinkAboutHatter AC Permit App pg 2 001SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: IIII
M.
Name:
City:
Zip:-
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
SUPERVISOR
City:
Zip: Phone:
State:
BONDING COMPANY:
Name:
_Not Applicable
Address:
COUNTER
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit
no
:e thermit holder to build the subject structure
or and covenants that may restrict or prohibit such
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
-_"w ' 42
Signature of owner(,WLessfee
STATE OF FLORIDA"
COUNTY OF
The forgoing iostmaent was K acknowledged fore me
this day of 20 _ by r_. Q�_l
(Name of person acknowledging
(Signature of Nota ublic-State of Florida)
Type of
Notary Public - State of Florida,
Commicuion # Gfa�RAli8
My Comm. Expires Aug 21, 2020
Revised 07/15/2014
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Signature of Contractor/Ucense 061cler
STATE OF FLORIDA
COUNTYOF 5+•We.
The fo oing instrument w acknowledged before me
this 15& day of �20--id by
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(Name of person acknowled ng )
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( le
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(Signature of Nota blit- State of Florida i
Type of
Notary Public - State of Florida
Co -mission # GG QNO
My Lamm. Expires Aug 21, 2020
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS