HomeMy WebLinkAboutBuilding Permit Application (2)SUPPLEMENTAL CONSTRUCTION LIEN LAW IN FORMATION.
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: � Not Applicable
Name:
Name:
Address,
Addrew.
City: state.
City- State:
Trp: Phone
Zip: Phone -
FEE SIMPLE TITLE 1-IOLMR tot Applicable
BONDING COMPANY- Not Applicable
Name:
Name:
Address:
Address:
City:
Y:
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, Line Courity makes no representation that is granting apermitwill authorize the permit holler to build the subgectstructure
which is in conflict with any applicable Home Owrnm Association rules, bylaws or and covenants that may restrict or prohibit subs
structure. Please consult with your Home Owners Association and review your deed for any restrictions Mich 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 F7arida Suilding Codes and St. Lucie County Amendments_
The foliawing building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimn6ing pools, fences, walls, signs, screen roorm and accessory cases to another noes-re-Mential use
WARN ING TO OWNER: YoLw failure to Record a Notice of Commencement may result in your paying device for
improvements to your property. A Notice of Commencement roust be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
e�csrnmencing work or repDrding Vour Notice of Commencement.
Signae_ JCcaritractor as Agent for Owner Signature of Cors Holder
STATE OF FLORjbA STATE OF FLORIDA
COUNTY OF_ _ COUNTYOF
The forgoing iru;tru ,rsentwas acknowledged before me The forgoing instrument was a*nowledged before me
this day of C re 2Q ^ by thisF_6 dayof ttncic? +f 20_!Ef by
Warne of person making staternent. Name of person mal;iitg statement.
nally Known QFC Produced Identification
Of Identification
JOSE �RESNILLO
a State of florid;w-Notary Public
('Yign of S i R E K�YQ S
iii`' Frh' ; ernber 22, 2022
Cominissson N'
ii
FRONT ZONING SUPERVISOR
IJNTER _ REVIEW REVIEW
COMPLETED
Personally Known OR Produced Identifikation
Tvue of Identification
,551,tl��r.. JOSE FRESNI
5
a'vSeate of FCarida-Nota
(Signatu otaryPublic-$ ammisseor,#fsG
']� %, rrsrerr�� ixeco rn{yer t., MY CommiSSion E
�,+
Cs�rntrnssion NO.
PLAINS I VEGETATION I raEAYURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW