HomeMy WebLinkAboutPage 2 Permit for 11039 Muller RoadSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name:_
Address:
City:
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INEER: x Not Applicable I MORTGAGE COMPANY: Not Applicable
Name:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
State:
Not Applicable
Address:
City: State:
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BONDING COMPANY: )C _Not Applicable
Name:
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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.
5t. 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 FALURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT N 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
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re of Owner/ Les a/Contractor ent for Owner Sign a of Contractor/License
STATE OF FLORID - STATE OF FLORIDA
COUNTY OF )1A,& COUNTY OF !��
The f r ping instrurpqn as acknowledg before me
thisW day of 20 by
Name of person making sta ent.
Personally Known OR Produced Identification
Type of Identification
The f ing Instr t s acknowledged before me
this day of 20• ' by
Name of person making statement.
Personally Know DR Produced Identification
Type of Identification
Produced
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