HomeMy WebLinkAboutTurner pg 2SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY:( Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: —
Not Applicable BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip:
Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT_"
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORID,
STATE OF FLOR DA
COUNTY OF ,'�'( Cer-� v�
COUNTYOF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 14 day of 3Lci e 20_�!j by
this f 4 day of 20 t'�7 by
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Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification t/
Personally Known OR Produced Identificationy
Type of Identificatio
Type of Identific ' n
Produced L lJ L
Produced �— t
r. ETH J ALEKS
v`., €YSA$Er4 J ALEKS
(Signature of Not _ ' t�' �I pate o on a
GG 329628
(Signs ure of NoTy�date f¢ P GG329628
ofr.1 on
�Ay Comm. Exp4res May t, 2023
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� (,, CommExaires May 1, 2423
Na tarry Assn.
Commission No. " 1' dk ihrough �Sdaol Notary Assn.
Commission No.�orT rough ye
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19