HomeMy WebLinkAboutpermit lux new 2SUPPLEMENTAL CONSTRUCTION LIEN LAW
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
INFORMATION:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
,
V VV IV CK/ LVIV I KAL I VK Ahl-IUVI I : 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 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 lender or an attorney before commencing work or recording your Notice of Commencement.
Signatlj►'e of Own
STATE OF Fl.
COUNTY OF
Corey Miller ^g1�k9S�b9C�M,1e,
Ja1e: 2020 10.0912 -IN W
as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF Stlucie
Sworn to (or affirmed) and subscribed before me of
2 Physical Presence or Online Notarization
this. day of a : - c ✓ 2020 by
Ke Lr 01 111
Name of person making statement.
Personally Known OR Produced Identification 14 e S
Type of Identification
Produced ! C '«(ct� ss A
(Signature (& Notary Public- State of Florida )
�o a`v Fra MARY LEF MATTIS
Commission No ('q yam* ��- COMMISSION # GG 064
N; EXPIRES: March 6, 2021
Bonded Thru Budoet Notary Sa,
Sworn to (or affirmed) and subscribed before me of
"Physical Presence or x Online Notarization
this 7 day of October 2020 by
Corey Miller
Name of person making statement.
Personally Known OR Produced Identification U ti!;
Type of Identifica ion t } �—
Produced
Vit
(SignaturcHWNotary Public- State of Florida )
�� .".ek.*f N WAY LSE MArnB
Commission No. 60L'164. My COMMISSION # GG 0
^� o� EXPIRES: March 6, 20
y'Fur r��Bended Thru Sudoat Notary .'
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED