HomeMy WebLinkAbout7.16 permitSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIIDVIT: 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE .SOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITU-YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUA&TICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner I Signature oyContractor/License Holder
STATE OF FLORIDA jj •., STATE OF FLORIDA'
COUNTY OF s y-lA_c�c L COUNTY OF
The forgoing instrurrent was acknowledged,�efore me
this _.- I _.Vday of 3 s�� 20r��✓ by
Name of person making statement.
Personally Known OR Produced Identification
Type of ldentifi °n Erik Nemogal
Produced ✓r--G9mm15SI0n # GGi01442
=_
Expires: May 4, 2021
r o�� Bonded tliw Aaron Notary
.(Signatur66f Notary Public- State of Florida )
Commission No. (Seal)
The for oing instrurrnt as acknowledge •fore me
this d a of y
Name of person making stat ment.
Personally Known OR Produced identification
Type of Identifici4tion, ran r
Produce '�•,�! Efik Nemoga
Commission # 6GIO14
-� Expires: May 4, 2021
, Bonded thru Aaron Not
(Signature Notary Public- State of Florida )
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. 2/f/!9