HomeMy WebLinkAboutDean Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIOR.,
DESIGNER/ENGINEER'
Name_
Add res s
Not Applicable
City: state -
Zip: Phone
FEE SIMPLE TITLE FOLDER: Not Applicable
Name:
Address,
City;
zip: Phone; -
MORTGAGE COMPANY: � � Not Applicable
Name,
Address,
City : state:
Zip; Phone;
80.NDING COMPANY: Not Applicable
NiPMP-.
Address.-
city -
zip; phone:_
OWN ER/ CO NTF ALTO R AF FIDVIT: Appl Fcatic-n is hereby made t o o btairr a pet raft to d o the woe k an d I n stall anan as i nd icated-
I certify t h at n o work or i n st al I ation has commenced -pr I o{ t 0 the I SSU ante of a perm i[ .
St. Lucie -Co u nt makes no represe n to tGon that i s granting a per rnit will a-uthorat a the pe rm I t hol d er to h wild the subject structu re
wvhich is. i n c ()nfl id wit h a n y+ a pp I I ca bl a Hom-e owuners Assaotat I on rule S, bylaws or a n a Cove n ants that tn, festrl-Ct or pr Dhihit su-c h
-Aructure Fl1ease consuit with your Hiarne Owuners Association and review your dee-d for any fistrIetionswhich may appky
In eon si der at i Gn of t h e gra rrt i ng of khks reque Sted Re rmit, I do hereby a gree 0a 11 w i 11, i n all r@SipeCtS, perforrr7 the wor k
in acc cIrda nce wi th the a ppr oved pla n-5, R he F I or,da Bui Iding Codes and St. Lu cie Co u r+ty Amendm a nts.
The fo li-Dori ng bui I d i ng pe rM I t a;pPlic at io ns a re a KeMpt from undergo i n g a full c oncur re n CV revgew - room addibo n 5.
&ccessory structu res, swi mm i ng pool s, fe aces, wa Cis, sig n sF w reen room S a n d at cesw ry u yes to a rl tithe r non, residen tia I use
WAIF N I N G TO OW N E R: You r fa i lu re to R ecord a Matite o I Commen cement m3Y -re s jilt 1 n paying twi ce f o r
of St.
irnproveme-nts to your property. A N-DUce of Corrtmencem-ent must be recoe d trded in the
�ubli
n`ar� ir7gr-Erecord o Tuft
L4. d e CC u my a nd poste d on the io bs I to be fore the f i rst 1 ns Ci ro - f V Oo
with der or an attorney comrrtenctn oak �� re k ��r �lotiC� of Commencement. _
5wgnat fe O r Lessee Cantractor as Agora for Owner
STATE OF FLORIDA +
j COUNTY OF
svvn to (OF off irme d I and su bsr ribe d before me of
R sical Presence or - Online NDtarization
Ihi5 day of , 2020 by
Name of per}on making statement.
Personally Known _ OR Produced identification
Type of Identification
Noducedl
t
1 Signat u re of Not ary P ubl ic- State of Florid a
Commission N06K q l
REVIEWS
DATI
RECEIVE
DATE
COMRLET
e-
FRONT �I
--�CkNTER R
Signs# of cork # act LicLicense idoldeF
STA4 OF FLOJIDA
COUNTY O l' i-A E—
' .5worrl- IQ lix a(f;rtnedJ and subscribed before me 4f
x Ph-qSrcal Presence or _ OnItne Notarization
this 31sr day o f JULY . 2020 by
JAIEl K PHIL IP5
lame of Der wn making 5taterncnt.
Personally Known x OR praduded IdentiIII cattOn 'Type Of 1 den [if f atl on
Produced
�Sigirat
NoiatyPUblIG Gi11a� Florida
earn ra C $enia n
E i �r% r-1 +4 � r+€ �a a l Al
of Notary Public- St ate of Florida
EGETATION 1;vnluvL
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