HomeMy WebLinkAboutBuilding Permit Application (2)I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
_ wvr. APPrscaore i MORTGAGE COMPANY: _ Not Applicable
Address: Address:
City. State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
UWPILK/ LUf4I KRL [Eli€ A1-HVVIt: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify thatno work or installation has commenced prior to the issuance of a permit.
the permit holder to build the subject structure
r and covenants that may restrict or prohibit such
-ed 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 Suiklrtg 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, wails, 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
commencine work or recordine vour Notice of Commencement_
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Signature of Owner/ LesseeKontractor Agent for caner
Signature of Contractor/Licenseder
STATE OF FLORIDA 4,JI ,,n'
STATE OF FLORIDA a-
COUNTYOF
COUNTYOF I.,/(,6
The forgoing ins, mentwas acknowledged before me
The forgoing instrument was acknowledged before me
this�dayof >�{ 20j°I by
thisdayofAt 2019 by
titich6 F SOV I ,
Wcw F t�
Name of person aking stitement
Name of perso along stat went
Personally Known OR Produced identification
Personally Known OR Produced Identification
Type of identification
Type of identification
Produced
Produced
ucQ�
(Signature o N ublic- State of Florida)
{Signature iitv9i��s
Commission Q.`.'"r"��CHgISTINE J. ILZIELL
• ry ublic - State of Flyrida
Yp�, a;ats?iNe J. ZFI
Commissi , e, Notary Pub iron #tGtG[da
•�''
�'. Aug 2S, 2020
`? Commission # GG 017869
4._ - My Comm. Expires
M COMM�';
onded through National Notary Assn. _
Bonded
hrough National Not
yA
REVIEWS
VISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 812/17