HomeMy WebLinkAboutRon Raymond 11600 Twin Creeks Dr Electrical Permit pg2SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 1
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable ! Name:
Name:
Address: Address:
City: State: l City: State:
Zip: Phone
Zip: Phone: j
FEE SIMPLE TITLE HOLDER: — Not Applicable BONDING COMPANY: Not Applicable
Name:
Name:
Address: Address:
City: City:
Zip:Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVtT: 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 such
structure. Please consult with your Horne 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, wails, 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 commencin work or recording your Notice of Commencement
Signature of Owner/ Lessee/C n ctor as Agent for Owner Signature of Contractor Lic % e Holder '
l
STATE OF FLORIDA �` i`. STATE OF FLORIDA III
COUNTY OF _ COUNTY
OF
Swgr'n to (or affirmed) and subscribed be re me of Swor to (or affirmed) and subscribed
Physical Pracp-.-o .,r Onii Notarization f bed before me of
P1�y.�I Pre5eyace or lin otarization
this22ndday Gf Q. ecgMbQL '�, 2020 by thiQ2ndday of December o b y
__— _ —
Name of person making statement. Name of person making statement.
J
I Personally Known ° OR Produced
Identification Personally Known' _ OR Produced Identification
Ty e of Identification
Prduced p Type of Identification
i Produced !
t Itit S1i,r" Ii I
{Signature Notary Public- St $ GARC
a STACEY GARCIA (Sig ture of N ary Public- Stat I MY coMMISSION GG L318
=
MY C4MMiSSIQN GG01 a1) II i ,, t_ EXPIRES: May 16. 2
i Commission No I) (� .l Veal) EXPIRES: May 20 1Com ission No. i ri
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`�°' isiaP•` s�'xie�i Thni Notary Pubic U S Mm g , ! }q..-.TF.^.k r' 1J'-� 7`''' IU NO
REVIEWSt
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE l
COMPLETED
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