HomeMy WebLinkAboutSayer AC Change out Permit App pg 2 001SUPPLEMENTALCONSTRUGTION 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 the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or andcovenantsthat 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, l 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
commencing work or recording your Notice of Commencement.
4l4z yrs A,Z� a��
Signature of Owne ssee Signature of Ctmiltractur/Liceffe Holder
STATE OF FLORIDA
COUNTY OF IMI
The forgoing in rument was acknowledged before me
this jday of_ 20 by OSV
(Name of person acknowledging)
(Signature of Nota Ic- State of Florida )
Known ,
Personally OR Produced Identification
Type of Identification Produced
CHRISTINE J. CO(}kPall}
o y Ru31ic - State of Flonda
Commission # GG 0170170
National Notary Assn.
STATE OF FLORIDA l t •, I
COUNTYOF 3 . IOW(/
The for forgoing instrument was acknowledged before me
this Iday of beaofl . 20� byeco
Is
M,itW LA -z
(Name of person acknowledging)
(Signature of Notaryf - State of Florida)
Personally Known OR Produced Identification
Type of identification Produced
CHF. STINE J. C4NIerBlj_
Notary Public - State of Florida
My C, =.;M, Expires Aug 21, 2020
Sonde, through National Notary Assn.
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