HomeMy WebLinkAboutApplication}
SUPPLEMENTAL CONSTRUCTION.LI'EN'LAW
- - --------
DESIGNER/ENGINEER: _Not Applicable
Name:
Address:
city6: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _Not Applicable
Name:
%.
Address:
City:
Zip:0
Phone:
N F 0 R M ATI 0,:N'&'%
MORTGAGE COMPANY:
Name:
.. '.'ii'..J - _£.. �. 'JC�GC'-•.f •- :�":J. ,-�YX -OW,
i iy .J'?: �• LLL 4- - .'.Y
{� • ,_ .•;:..,�. •r#�'..�$
Not Apploicable
Address:
City: State:
Zip; Phone:
BONDING COMPANY:
Name:.
Add res
ZIPO one:
_ Not Applicable
OWNER/ CONTRACTOR AFFIDVITO Application is hereby made to obtain a Pr-1 III o 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 Count makes no representation thatis granting a permit will authorize the permit holder to build the subject str4 ucture
which
urenPleaslecconIsulany
with ppoivaHlome Owners
siat*ion
drreviebylaws
odeed focovenants
trithat
hswhirestrict
or
pply bit such
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 A mendments.
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
imour propertyComd ihblic records o
Lucie County and psted on the i . do
P osted on the *obsiteobsite before the first inspection. If you intend to obtain financing, cor
with lender or an attorney before commencing work or recording your Notice of Commencement.
Signaturew.caner/ Lessee/Contractor as Agent for Owner Si a re of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA . .
COUNTY OF � • �1_ -�2 COUNTY OF.PM
Sw�o (or affirmed) and subscribed before me of
�` Physical Presence or Online Notarization
this �� day of l�C�m—Cv,-- , 2020 by
LJ
Name of person making stament.
Personally Known V..' OR Produced Identification
Type of Identification
Produced 'k,
(Signature
U� %
MUM,
Notary Public- S
Commission No...
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
ev. 516/ zu
ILA
FRONT
COUNTER
M.
�/�► NotaryPublic state of Florida
�p ret E Montepare
— ' � B
Ior�+mission GG 214990
�*� .F
Fxpires 06105/2022
of _ _ _ ..
ZONING
REVIEW
SUPERVISOR
REVIEW
Sw(:)to(or affirmed) and subscribed before me of
Physical Presence or Online Notarization
jp�this � day of V " , 2020 by
Ck
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
j li, h
Ignatu 1
of Notary Public- State of
&cAmmlssion No,.
PLANS
REVIEW
VEGETATION
REVIEW
■ i 1
t St.
sult
Notary Public State of FI ida
I)Maig'',ret E Monliltep r
y :_ ., q9 My Commission GG 2 4 o
14a n� Expires 06105/2022
SEA TURTLE
REVIEW
MANGROVE
REVIEW