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HomeMy WebLinkAboutPERMIT 3211 SUNRISE BLVD. PG 2SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address: Address: City: State: I City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER:. _ Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: I Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicate 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 Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, 1 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 Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consi, with lender or an attorney before commencin work or recording our Notice of Commencement. Sign ure of Owner/ Lessee/Contractor as Agent for Owner Sigr,4ture of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF SAINTLUCIE COUNTY OF SAINT LUCIE Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of X Physical Presence or Online Notarization x Physical Presence or Online Notarization this 13 day of JANUARY 2020 by this 13 day of JANUARY 2020 by JAMES W LAW JAMES W LAW Name of person making statement. I Name of person making statement. f Personally Known x OR Produced Identification Personally Known x OR Produced Identification Type of Identification Type Identification ProducedA �'Ay 'el6e Pro ed. Z A6z a,& JZ YPWO Lida) (Sig a oVEEN CommissionOF FLOR(Mal) GG262780 ignature of g Sit Florida NOTARY PUBLIC Commissio �ORipA (Seal) �; Conan# GG262780 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE I RECEIVED DATE COMPLETED I_ Rev.