HomeMy WebLinkAbout5804_balcony_permit app pg2SUPPLEMENTAL CONSTRICTION LIEN LAW INFORMATION:
DESIGNERIENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: X Not Applicable I BONDING COMPANY:
Name:_
Address:
City:
Zip:
Phone:
Address:
City:_
Zip:
Phone:
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 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 attek.ney before commencing work or recordi our N tice of Commencement.
Signature of Owner/
STATE OF FLORIC
COUNTY OF
as Agent for Owner
Swor -to (or affirmed) and subscribed before me of
:! sicaI Present or Online Notarization
this day of 2020 by
Na of person makin{Wstatement. s
Pe s ally Known OR Produced Identific0 "
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ture of Notary Publice5tate of Florida )
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Signature of Con ractor/ ice se Holder
STATE
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COUNTY OF (�] cs�
5wor (or affirmed) and subscribed before me
of
Physical Prese ce or Online Notarization
this ty of •-� 2020 by
person makin atement.
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Known OR Produced IdentlflcatWn,-'
Type of Identification
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REVIEWS
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VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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REVIEW
DATE
RECEIVED
DATE
COMPLETED
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