HomeMy WebLinkAboutPermit Application (2)SUPPLEMENTAL CONSTRUCTION
LIEN LAW
INFORMATION:
SUPERVISOR
DESIGNER/ENGINEER: _ Not
Name:
Applicable
SEATURTLE
MORTGAGE COMPANY:
Name: Navy Federal credit Union Mortgage
_ Not Applicable
Address:
REVIEW
REVIEW
Address: PoBox33N
REVIEW
City: State:
Zip: Phone
REVIEW
City: Mem
Zip: 221+9 Phone:
State: vA
FEE SIMPLE TITLE HOLDER: _ Not
Name:
Applicable
BONDING COMPANY:
Name:
Not Applicable
Address:
RECEIVED
Address:
City:
City:
DATE
Zip: Phone:
Zip: Phone:
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.
St. Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
which is in contlict 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 W 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. IL YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER I
of
AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Agent for Owner
STATE OF FLORIDA �j
COUNTY OF . f` C Imo,
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
Thefor g instrument acknowledged before me The forgoing instrument was acknowledged before me
this a of w1 20X by this day of 20_ by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identifica "o
Produced FL "� H LC�L —� — (4 . %07,
MY
Commission No.
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No.
(Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED