HomeMy WebLinkAboutIMG_20200508_113002165SUPPLEMENTAL CONSTRUCTION LIEN II INF=ORMATION.
MORTGAGE COMPANY:
N< Hie
Address:
City:
Zip: Phone:
DESIGNER/ENGINEERO
Name:_
Address:
City:
Zip:
Phone
Not Applic:,,lbl{i
FEE SIMPLE TITLE HOLDER:.._.... Not Applicable
N a nye :_______•-._�-__�.._ _.
Address.. �.
City:_________-�
Phone:
BONDING t:+C MPANY:
City:�
Zip: Phone:_____
Not Applicable
State: _____---
Not Applicable
Application is by rli�rdr to obtain a permit
do the work and installation as indicated.
OWNER/CONTRACTOR AFFIDVIT. App hereby
I certify that no work or installation has commenced prior to the issuance of a permit.
Lucie Coun makes no representation that is granting a pt Association ruleswill ,byl ws or and covenants that may uthorize the permit holder to drestrict or prthe subject o hibit such
wtructure
Luc X applicable Home owners
which is in conf ict with an app • y apply.
structure. Please consult with your Home owners Association and review your deed
oin all respectsoperform the work
In consideration of the granting of this requested permit, I do hereby agree that I will,
Amendments.
in accordance with the approved plans, the Florida Building Codes and St. Lucienour County
review: roam additions,
The following building permit applications are exempt from undergoing a Ful
accessory
structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-resrdent�IOUR PAYING
"WARNING TO OWNER: YOUR FAILURE TO RECORD A WOTICE OF COMMENCEMENT
I CEMENT MUST BERECORDED AND
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE O
POSTED ON
THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO MENCEM I�lIjC1NG, CONSULT
yflTtl YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
of caner/ Lessee/Contractor as Agent for uwnei
STATE OF FLORIDA
CO U NTY OF St Luae
The forgoing instrument was acknowledged before me
this day of L , 20 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Idenication
Produced_ .
n "ore of l ontractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this � day of 12"�',r'` . afl by
Name of person malting statement.
Personally Known ___ OR Produeed IdentificcatiOn
Type of Identification
Produced____
♦ l t 't'Ihll`lI1C"
g re 4NOPo4blic- St c.,F rida) gilatur� e.f ti ,?���r(Si HatoGawroSv�i,II�SEFN _ k , •�"
Notary Pubhc State of Fton , + `'
_ - _ , �..,.<.�'�
E 2,55040
(?C11r11ission NOA "ti
{Seri mm,sstnt; X GG j:, .. :
Commission No.
My Comm. EN arts Sep 3,2 :
1 _
REVIEWS FRONT ZONING yt1PERVISt?R PLr1N� VEGETATIONEVIEW
1 SEA TURTLE M ANG_RON* kE
iEVIEW
COUNTER RL -VIEW REVIt.V1! FE�$IE� R
DATE ..�
RECEIVED
DATE
CfJMPLETED
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