HomeMy WebLinkAboutbuilding permit (2)SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone - Zip: Phone:
FEE SIMPLE TITLE HOLDER: _X_ Not Applicable I BONDING COMPANY:
Name:_
Address:
City:
Zip:
Phone:
Name:
Address:
City:
Zip: Phone:
Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application ishereby 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, fence's, 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.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
�(w:ee
STATE OF FLORIDA '
COUNTY OF ?.
COUNTY OF
Swor to (or affirmed) and subscribed before me of
Physical Presenc or Online Notarization
this day of 2Q2t7 by
Swor (or affirmed) and subscribed before me of
Ph sical Presenc r Online Notarization
this day of 2t]2t] by
Name �of person making statement.
Name of person making -
Personally Known'Y OR Produced Identification
/statement
Personally Known V OR Produced Identification
Type of Identification
Type of Identification
Produced
�
Produced
p
(Sig tur�e,,gf NoW16R4;b9o-*W f6l° rid )
Suzette Ritchie
t��1� My commission GG 135736 [�
Com $ 1jF0� /.Y6� t= .tee 12 91242j (S 1)
(Signat e�ofr anpli bl t �ii 4da )
Suzette Ritchie
CommMy Commission GG 135736
Ca IL�OF Exoires iW1Z2421 (Se 1)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED .
DATE
COMPLETED
Rev.5/6/20