HomeMy WebLinkAboutbuilding opermitSUPPLEMENTAL CONSTRUCTION LIEN LAW (NFORMATInnr•
NER/ENGINEER:
Name:
Address:
City:
Zip: Phone
FEE SIMPLE TITLE H LL EO DD R
Name:
Address:
City:
Zip: Phone:
_ Not Applicable
State: T
____ Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
—Not Applicable
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
structure. Please consult with your Home Owners Association and review your deed for an 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 such
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. Y
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
TWICE FOR IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
POSTED ON THE ,DOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YO ER OR AN ATTORNEY BEFORE RECORDING
OTlCE OF ENCEMENT."
Signa�ui-e o Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OFStLuele
STATE OF FLORIDA
COUNTY OFSt Lucie
tense Holder
The forgo) 'ng ins ant wa _acknowledged before me
thisy cr ' _ 20 by this The forgping instrument ,.,ns acknowledged before me
ay 0f 20 by
Don Miranda
Name of person making statement. Don Miranda
Personally Known xxx OR Produced Identification
Type of Identification
Produced _r
(Signature of Notary Public -
Commission No.
REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
Lori Diodato
ftmission # GG01
Expires: Feb. 9,
Name of person making statement.
Personally Known xxx OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- St a) Lorl Diodato
;ommission No. a,ssi COmml On GG0
Bonded thru Aaron I
SUPERVISOR I PLANS
REVIEW REVIEW
VEGETATION I SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW