HomeMy WebLinkAbout7337 Sea Pines - Permit App Page 2SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER: u� Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
PEE SIMPLE TITLE HOLDER: i"f Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
Name:
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 commented prior to the issuan, a 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 attorne before commencing work or recording your Notice of Commencement.
as Agent for Owner
STATE OF FLORID/ l STA�OF FLORIDA
COUNTY OF � LC�& e— COUNTY OF IJ -
Sworn to (or affirmed) and subscribed before me of
P ysical Pre ence or ✓ Online Notarization
thi day of 20Z0 by
Name of'15erson making statement.
Personally Known v OR Produced Identification
Type of Identification
Produced A
Sworn to (or affirmed) and subscribed before me of
Physical Presence or � Online Notarization
thi y of 202��by
f
Nam tof pe son making statement.
Personally Known ✓ OR Produced Identification
Type of Identificat�gn
Produced... „ 4
tsignature of NotPUbli - Florida)
LJ i lll���
na ure of No - ida
Commission No.
`"���tiia
N� YA -SSION
q tq y4SPalj
Commission No. 23` al
23 .'•,,�
REVIEWSkfIRtONT
•• pNl SUPERVISOR
#Cc i3kbky
PLAINS VEt9%VQ% AT,L1l MANGROVE
REVIEW
REVIEW RE A�'�REVIEW
DATE
RECEIVED
°er�Ea as '�'V
., .• cno\���
�ii li
'���1lll' & ATE%',����
DATE
��Ulniiiu•
COMPLETED