Loading...
HomeMy WebLinkAboutBuilding permit application, pg 2-SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: ' DESIGNER/ENGINEER: Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address: Address: City, State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable Name: BONDING COMPANY: Not Applicable 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 confiictwith 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 our Notice of Comm cement. VA Z Signature of/caner/ Lessee/Contractor as Agent for Owner Signature of ntrac or/License Hold r STATE OF COUNTYOFOR[DA STATE o yt�ecbob(2Q COUNTY OFDRlDA V othobet SwoT to (or affirmed) and subscribed before me of E�ysical Presence or Online Notarization this . 1 day of 0 C 2020 by VN Hl� kC Name of pers aking statement. Personally Known ✓ OR Produced Identification Type of Identification Pr uced " 'Eta rr dut1a H. III 7sidilature of Notary Public- Stat : &� 1y COMM355fOtef # Commission No.cc.�I REVIEWS I FRONT ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED February Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization his t4V%day of QC�o mac' 2020 by_ �s1— -��A ztez��—� [ Na a of per/on making statement. Personally Known ✓ OR Produced Identification Type of identification Produced " JULIE H. RAY Si t re of Natary Public- S ' i ffPOMlMISSION # GGi G g q r/% �f p EXPIRES February 0.2. 2CgRl'lis Son No.(-16c t`E SUPERVISREVIEWOR REVIEWVEGETATIEVIEWON 5 REVEWLE M EV EWVE