HomeMy WebLinkAboutBuilding Permit App 2SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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DESIGNER/ENGINEER: _Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: FRANK UEBLER
(dame; N/A
Address:2254 6TH AVE S.E.
Address:
City: VERO BEACH State: FL
City: State:
Zip:32962 Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: —Not Applicable
_
Name: BELINDA / SCOTT SIME
Name:
Address:6000 RIVIERA DR,
Address:
City: CORAL GABLES
City:
.Zip:33146 Phone: 786 344 9579
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 conflict with any applicable Home Owners Association rules, bylaws Oran 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
LucieCounty and post d on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender o an a o e before commencing work or recordingour Notice of Commencement.
tgnature of Owner/ Les'ee/Contractor as Agent for Owner
ignat reell C tract r/License Holder
STATE OF FLC(� A
STATE OF FLORIDA
COUNTY OF ( ✓ 1� Cf
COUNTY OF
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Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
_ Physical Presence or _ Online Notarization
this! day of fir'PMheY'_.2020 by
this Zday ofD6CP.Vvtic�+V .2020 by
N►I'VidaLcsirro
(�regarq rI- yLnS
Name of person making statement.
Name of erson retaking statement.
Personally Known O roduced Identificatio
Personally Known O roduced Identification
Type of Identification
Type of Identification
Produced V,4�t/(1✓
Produced 'I%n&y Ufgw P_
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(Signature of Notary Public- State of Florida)
Signature of Notary Public- State of Florida �n
Commission No. 3 d` rN{ IMpuWState of Florida
Garcia
mmission No.� r ,�w� a'" PubhC State of Fiond
� tR' 'llBautista Garcia
Paola t3autista
My Commission HH 063683
: My Commission HH 063683
Ex fires IJM512024
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