HomeMy WebLinkAboutpermit application p2SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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:
City:
Address:
City:
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 priorto the Issuance of a permit.
St.
Is In conflicmtawith any applicablelHome Owners tAssociationl rulesabylaws or and covenants that may restrict or prohibit such
structure. Please consult w th 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 IN 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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT-"
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lature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLO IDAI STATE OF FLORIDA
COUNTY OF } . e COUNTY OF S}, Loi-IP—
The
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The for oing instrurr7��nt was acknowledged before me
this day of ISIS 'I 2p21 by
Name of person making statement.
Personally Known OR Produced Identification /
Type of Ideq$ification
Produced rL. of iM =
Commission No.
REVIEWS
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Notary Pubic State of Florida
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Theforgoinginstru nt was acknowledged before me
this f- /►1111/ 2092 by
I%!,J_. n_.LL,
Name of person making statement. /
Personally Known OR Produced Identification V
Type of Ider�t�f Hca Ll i�fS r,
Produced i-` T�
of Notary Public -
Commission No.
FRONT I ZONING SUPERVISOR I PLANS I VEGETATION
COUNTER REVIEW REVIEW I REVIEW REVIEW
Notal Public State
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- an Explrea 08�28r6I 1021
SEATURTLE MANGROVE
REVIEW REVIEW