HomeMy WebLinkAboutBuilding Permit ApplicationIf value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERf ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
City:
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 Co
which is in <
structure. P
hakes no representation that is granting a permit will authorize the permit holder to build the subject structure
:t with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
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 accordancelwith the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following puilding 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'
improveme
before the 1
commer,4in
0 OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
is to your property. A Notice of Commencement must be recorded and posted on the jobsite
rst inspection. If you intend to obtain financing, consult with lender or an attorney before
work or/ecording your Notice of Commencement,, 14
LIS41--, I
oe .
Signa re oflowner/ Lessee/Contractor as Agent for Owner
Signa e of Contracto /License Holder
STATE OF FLORIDA
STA E OF FLORIDA
COUNTY OF Sj Lex Q
,
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledg d before me
this M' day of 20AJ by
this _nday of 20 -IT by
Name of per on making statement.
Name of person making statement.
_�OR
Personally Known AOR
Personally Kown Produced Identification
Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature cf Notary Publi
ignature of Notary Public- St ) KRISTEN L BENSL
-4' 7(Dgt2S ,`t'►"'vP�''�, KRISTEN L BENSLEY
4r9�4CiS = Notary Public - State of
,
Commission No. = r: °,'s_ (Wait Public - State of Floridmmission
MAF
No. a, �ealgommission #t FF 97
J Commission M FF 970x05
�'�; o� ; My Comm. Expires Mar P
1. ` ?o M Comm. Expires Mar 10, 2
20
REVIEWS
FRONT
rm
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 1/9/2019
P, 0020