HomeMy WebLinkAbout002SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: TRI-COUNTYALUMINUM,INC
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: 6M HICKORY DR.
Address:
City: FT.PIERCE State: FL
Zip:34982 Phone-m-a9+-09s3
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Assocaion rules, bylaws or anScovenants 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
PASTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WRY YOUR -LENDER OR AN ATTORNEY BEFORE RECORDINGiIWR NQIICE OF\COMMENCEMENT."
Signature of essee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIgA
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STATE OF FLORn
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COUNTY OF u�IU
COUNTY OF
The forgoing instru ent was acknowledged before me
The forgoing instru ent was acknowledge before me
nday
this � day of 20�t by
this of C n 20 by
Name of person making statement.
Name of person making statement.
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Personally Known_ZOProduced Ident'fiication
Personally Known Produced Identification
Type of Identification
Type of Identification
Produced
Produce
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(S' ure of N�ar-tjb is -I I n
mda Carol Collins
AAy Commiaaon �yG 3p9344
Commission NO.) poi. Expires 03/09120�eall
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P ry Pu he late o Florida
Linda Carol Colli �i ,`
Commission No d'- M Commission G�JW4
orn XPIM503/09/2023
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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