HomeMy WebLinkAboutbuidling permit (2)SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable I BONDING COMPANY: _XNot Applicable
Name:_
Address:
City:_
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 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 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 in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St,
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
U�d_ L�- l�n�tJ ,.- - -- - -
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Signature of Owner/ Lessee/Contractor as Agent for Owner
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Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
Sw to (or affirmed} and subscribed before me of
Sw n to (or affirmed) and subscribed before me of
sw P ysicaI Pres nce or Online Notarization
P ysical Prese ce or Online Notarization
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this day of 2020 by
this day of 2020 by
0 ccM� Yam- L am- -
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Name of person making statement.
Name of person making statement.
t"_�
Personally Known V/ OR Produced Identification
Personally Known OR Produced ld�ntification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida }
(Signature of Notary Public- State of Florida }
Commis State of Floral
Commission No.
y,;t—fie
r° Suzette Ritchie
mission GG 135738
�Y Pt, Notary Put�lic State of Florida
' �.xp r9& 12112
'?bF
REVIE
2021
UPERVISOR
PLANS.
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. ory
- As 1'rtTURTLE
ssiRn GG 135736
ANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED -
DATE
COMPLETED
Rev. 5/6/20