HomeMy WebLinkAboutOakland Signature PageCI IPPI FMENTAL C O NSTRl IC'T!ON LIEN LAW INFORMATION-
DESIGNER/ENGINEER:
Not Applicable MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
_._ I Address:
City:
State: City: _ State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER.
_ Not Applicable
BONDING COMPANY: TNot Applicable
Name:
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.
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 consideraiion of the grarrLirig of Lhis requested permit, I do hereby agree UldL i wiii, in all respects, perform tine 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 roams 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 Lind ponied un the jobsite before the first inspec:tior]. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
I
STATE OF FLORIDA
STATE OF FLORIDA �
COUNTY OF 4 �1 4C
COUNTY OF - ux2f2
w rn to (or affirmed) and subscribed before me of
Phycal Presence or Online Notarization
Sworn to (or affirmed) and subscribed before me of
� Physical Pres nce or Online Notarization
this tlay of p� 2020 by
this �F�day of �� 2020 by
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Name of person making statement.
Name of person making statement,
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
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(Signature of Notary Public- State of Florida)
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REVIEWS
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SUPERVISOR
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