HomeMy WebLinkAboutBuilding Permit Application (2)SUPPLEMENTAL CONSTRUCTION UEN LAW RVORMATION:
DESIGNER/ENGINEER: _Not Applicable
Name:
MORTGAGE COMPANY: _Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permh 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 Counttyy 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 covenantsthat 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 1 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 ezemptfrom undergoing afull 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 IMPWV MENFS TO YOUR PROPEM. A NOTICE OF COMMENCEMBTT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INIa"PECIION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COM MEM.'
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Signat of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLO A
STATE OF FLORIpgC�
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The fo oing instru ent was acknowled a before me
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The fo oing instrument was acknowled ed before me
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Name of person making statement.
Name of pers n making statement.
Personally Known OR Produced Identification
Personally Known _,GOR Produced Identification
Type of Identification
Type of Identification
Produced ���
Produced
(Sig atureofNotaryPubli
PHILIP G. PEROTT
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REVIEWS
FRONT ZONING SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER REVIEW REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 217119