HomeMy WebLinkAboutBuilding permit app pg 2SUPPLI=M.ENTAf. CONSTRUCTION LIEN LA1111.
U IUlmLH/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip:` Phone_
FEE SIMPLE TITLE HOLDER: No
Name: t Applicable
Address:
City:
Zip: Phone;
:ORMATION,
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State
Zip: �.._.� Phone:__ j
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: _ Phone:
OWNER/ CONTRACTOR AFFII?VIT: 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. LucfeCounty 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, 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 roams 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 recordin ou N t'
7
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Signature of Owner/ Lesse on tractor as Agent for Owner
STATE OF FLORID
COUNTYOF ✓�—
Swoptito (or affirmed) and subscribed before me of
YY Physical Prese ce or Online Notarization
this 1 day of 202d� by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identific�C'on
Produce f 402 -D�
�'CD
(signature of Notary,(?. �jc- Sta,pb I
Commission No."` ,.j ,V* Con n1issioIt 1(�'G 56926
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Tnmrr ?9. 2022
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REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
BATE
RECEIVED
COMPLETE
r o :ce of Commencement.
Signa re Co ractor/License Holder
STATE OF FLORIDA
COUNTY OF n f ` 12i l/e,
SworTfta (.Cr affirmed) and subscribed before me of
✓✓ Physical Prese a or Online Notarization
this a i day cf U�� 2024 by
•e.
Name of person making statement.
Personally Known 3 OR Produced Iderttification
Type of Identification
Produce
(Signature of Notary P lic- State of Flo id j
Fr"' DOROTHY C LEGGETT
Commission No. ''`
'•, � Carnr�i�, ��>I,%1 GG 256926
,. `hq p s Sop{einbor 19, 2622
REVIEW VREVEWON SREVEWLE MREVEWVE