HomeMy WebLinkAboutPermit pg 2SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION;
DESIGNER/ENGINEER: Not Applicable TM03RTGAGE COMPANY 0
Name:
Address:
City:
Zip: Phone_
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
State:
Not Applicable
Address: Not Applicable
City:
Zip: � Phone:
_ � State:
BONDING COMPA Y
Name:
Address:
City:
zip: Phone:
.Not gppl aCI b elel
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a I certify that no work or installation has commenced prior to the issuance of a �permitto doy pethe work and installation
which is n conflict with any representation that
Asgoaation� �u esabthorize the permit as in
structure. Please consult with your Home Owners Association and rules
revibylaws or and covenants holder to build the s indicated.
In consideration of the granting of this requested permit, I do hereby agree thaw Your t I willeed �in all respects, hats ubJethi
in accordance with the approved plans, the Florida Building Codes and St. Lucie Count anyrestrictions hich ma or structure
y apply.
s
The following building permit applications are exempt from under oin y Amendments,
k
accessory structures,Permiag g a full concurrent re ments, orm the work
swimming pools, fences, walls, signs, screen rooms androom
"WARNING TO OWNER: YOUR FAILURE TO RECORD A accesso y view; m additions,
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A No OF ry uses to another
COMMENCE non-residential use
POSTED ON THE JOB SITE BEFORE THE FIRST INSpECj10N E
AYIWC
WITH YOUR LENDER OR AN ATTORNEY BEFORE REC OF COMM COMMENCEMENT
RESULT IN YOUR p
� ORD{NG YOUR YOU INTEND TO OBTAIN
BE RECORDED AND
OUR NOTICE OF CO AIN FINANCING
MMENCEMENT." r CONSULT
Signatu of Owner/ Lessee/C ra for as Agent for Owner
STATE OF FLORIDA
COUNTY OF cve
The forgoing it
nstru ent was acknowledged befor
this-'-) day of ,
20Oby $
Name of person making statemen M Z e Z
O M w
Personally Known % " N6
OR Produced Identificatic,
Type of Identification
Produced
0
ro
(Si a ure of Notary Public- State of Florida )
Commission No. b�� NWP41 JOANNEMEEHAN
eta, jdel�YCOMMtsSI0NNG00
� !' �, j� EXPIRES:Nowmber23,
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was ackno this — day of wledgeddged before
20, by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
ission No. (Seal)
REVIEWS FRONT
ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE _
RECEIVED
DATE - -- - j
COMPLETED