HomeMy WebLinkAboutwh st lucie 1.13.20.1SUPPLEMENTAL CONSTRUCTION LIEN LAND INFORMATION:
DESIGNER/ENGINEER- Not Applicable
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: Not Applicable
Nape:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: T Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
fume:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby madeto 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 County makes no representation that is granting a permit will authorize the permit holderto 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.
to consideration of the granting of this requested permit, I do hereby agree that l 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 RECORDER AND
POSTED ON THE JOB SIITE BEFORE THE FIRST INSPECTION_ IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENJDM OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT 7
Signature of Own / Lessee/Contractor as Agent for Owner
Signature of Contractor/Licen older f -
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STATE OF FLORIDA
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Commission No. dmrio 44
Commission No.
Expires, May 4, 202t
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