HomeMy WebLinkAboutWatson AC CHange out Permit App pg 2 001SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Appiicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
The forgoing instr ment>was acknowledged before me
this �dayof�204 by
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
ZIP: Phone:
ZIP: Phone:
OWNER) CONTRA
Notary Public State of Florida
Commission �;.` Commission 1{921$!#17839
21,2020
CTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that nttooy work or installation has commenced prior to the issuance of a permit.
St.
is inoconflictawith any applicable Homeeowners Asssociation rwill
esauthorize
by aows or and cove anis that build
ay restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, 1 do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. if you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your NritirA of
Signature of Owner/ Lessee/C &tractor s Agent Owner
Signature of Contractor/License Holde
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTYOF JI• I�
LIAt
The forgoing instrymenj as acknowledged before me
this �day of �(JtII 20A by
The forgoing instr ment>was acknowledged before me
this �dayof�204 by
Wlirhae-�-f � �wi�
Ml�et F Boy(2
Name of personing state ent
Personally Known V OR Produced Identification
Name of person ki g statement
m�
Personally Known V' OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
((ignatu gfIic-stamtSffFlbridG"WFLL
(Signat g,iatYft,�SyEKEo.
Notary Public State of Florida
Commission �;.` Commission 1{921$!#17839
21,2020
°��•`���, Notary Pubilc
- ��. ,? y State of (fFlorid
Commis r;(1, Commission # GG 01 M1 6
My Comm. Expires Aug
--"%°FI` Bonded through National No!ary Assn.
u .
-, o;
-,;F°F,, t My
Bonded through National Notary 0sno
A5om
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
!axr 217117
_.