HomeMy WebLinkAboutBuilding Permit Application (2) DESIGNER/ENGINEER: ,Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not-Applicable
Name: Name:
Address: Address:
City: 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 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 mayapply.
pprohibit such
structure.Please consultwithyouur Home Owners Association and review your deed for any restrictions which may a I
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 concurency 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 lengler or an attorne before commencing work or recording our Notice of Commencement_
5� re of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder .
STATE OF FLORIDA. �� STATE OF FLORIDA
COUNTY OF r.L ' - COUNTY OF
Sw m to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
P sical Pre ncq or Online Notarization. Physical Presence or Online Notarization
this day of 20ZO by this day of .20_ by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known. OR Produced Identification
.Type of Identficatio�} Type of Identification
Produced ` Produced'
(Signature of N tar Public-'State of Florida). (Signature of Notary Public-State of Florida)
tommission.#
KAREN SI,1i 'SEN SealCommission No f Florid dd�' r PublicCommission No.GG 207484M Commission Fxp'rPq
June 12, 202"
REVIEWS LU1111 Ku ISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED