Loading...
HomeMy WebLinkAboutBuilding Permit Application (2) UW C©NM TRU I + N LIEN MA W IHF@M&A 7WO: DESIGNER/ENGIN R: _ of Applicable MORTGAGE COMP NY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone:. FEESIMPLE TITLE OLDER: _Not Applicable BONDING COMPANY: _ of 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 thepermit 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"co icurrency 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 ur Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/Licdhse Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 1 . COUNTY OF �UC' The fogoing instr ent was acknowledg efore me The for oing instru ent was acknowledge efore me this day of 201,6_ by this day of ,201 by (Name of person acknowledging) (Name of person acknowledging) 12,-J I—AA4 I t , - (Signat re of Notary Public-State of F orida) (Signature of Notary Pu lic-State of Florida) Personally Known 000P-�e4 Personally Known OR Produced Identification Type of Identifica n,,.��ar KAREN S. NIELSEN Type of Identification vie .o c�;State of Florida Notary Public produced Produced nimicn # GG 207484 M Commission Expires �y`Ar q KAREN S. NI LSEN Commission No. % 0;,`,�°�` y _�° :State of Florid y June Sba 022 Commission No. r; Commission#BGG 207gggc My Commission Expires REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED - DATE COMPLETED - ev. 7/2014