HomeMy WebLinkAboutFrey permit application pg 2SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
i DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
f Name: j Name:
Address: I Address:
City: State: _ City: State:
Zip: Phone Zip: Phone:
rFEE SIMPLE TITLE HOLDER:_NotApplIcable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address: �T
City: _._._._.._ I City:
Zip: Phone:_ -, Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to otvain 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, Lucle County makes no representation that is granting aperrnit will authorize the permit holder to build the subject structure
is In
which 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. Lucre 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 joosite before the first inspection. If you intend to obtain financing, consult
with lender or an attor ybefore commencing work or recording your Notice of Commencement.
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Signature of Owner/ Lessee/Contractor a nt for Owner Signature of Contractor/License Hol[Ietv
STATE F STATE FOF1BRtH
COUNTYFOF7W I COUNTY
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�1// Pt ysical Pres ce r _Online Notarization Physical Prese ce or _Online Notarization
this dayof 2020 by this da of__ X2020 by
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REV'.EW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED