HomeMy WebLinkAboutBuilding Permit AppSUPPLEMENTAL CO S
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
UCTION LIEN LAW INFORMATION:
x Not Applicable
State:
_x_ Not Applicable
MORTGAGE COMPANY*
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
.X_ Not Applicable
ate:
_x_Not Applicable
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 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 suc
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. h
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 IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENC ENT MUST BE RECORDED AND
POSTED ONE OB SITE BEFORE THE FIRST INSPECTION. IF YOU INTE OBTAIN FINANCING, CONSULT
WITH �'OU LEN[*R OR AN ATTORNEY BEFORE RECORDING YQJUR NOTIC OF OMMENCEMENT."
/000� od�) 0 t-/ Uoc
Signature of Ow er/ Lessee/Contractor as Agent for Owner SignatL = ttl/
ure of Contractor/License Holder
STATE OF FLORIDA /�1� STATE OF FL�RIpA
COUNTY OF G/ l�� COUNTY OF Martin
The forgoing instrument was acknowledged before me
this _5�i day of lick y , 202' by
Name of person making statement.
Personally Known Lo' OR Produced Identification
Type of Identification
Produced----)
Signature of Notary
Commission No.
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
ev. 2t7T1
FRONT
COUNTER
to of FOMM N. STOKES
:* MY COMMISSION # GG 136487
pa EXPIRE�%§ffl mber 18, 2021
nded Thru Notary Public Undervellers
ZONING
REVIEW
SUPERVISOR
REVIEW
Thef rgoing instrument was acknowledged before me
this 8 day of may , 20_ by
Chris Woods 01LA � Ljood
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification
Produced
�j ,.:;�`A:+,i�," JAZMINE N. STOKES
�,. A :.: MY COMMISSION # GG 436487
Commission No. (Seal)
PLANS I VEGETATION
REVIEW REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW