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HomeMy WebLinkAboutSt. Lucie County Permit Application Schwertz Page 2SUPPLEMENTAL 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: 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. 1 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 tender or an attorney before commencing work or recording vour Notice of Commencement. St^r& of Owner Less as Agent for Owner e of Contractor o der Z; �OF�RIDA� 1 VTATEOF FLORIDA COUNTY OF 'mar' k U _ _ COUNTY OF Slill to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Ph sicpl Presence or Online Notarization Physical Presence or Online Notarization s day of 2020 by ..,_._.IJ `L. this day of 2020 by (\N v ` e 61 ifV Name of person making statement. Name of person making statement. Personally Known OR Produced ldentification4 Personally Known OR Produced Identification Type` f Ident' i Type of Identification P a ced Produced (Signature of Notary Public- tate of Florida) (Signature of Notary Public- State of Florida ] ram` '� E ©ARKRt i:JV Nata iC, State Florida Commission No. Commission No. (Seal) g of Commissionft GG 61 ^51 REVIEWS FRONT PLANS VEGETATION SEA TURTLE MANGROVE ZONING SUPERVISOR COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 5/1