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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.
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YPWO Lida)
(Sig a oVEEN
CommissionOF FLOR(Mal)
GG262780
ignature of g Sit Florida
NOTARY PUBLIC
Commissio �ORipA (Seal)
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
I
RECEIVED
DATE
COMPLETED
I_
Rev.