HomeMy WebLinkAboutbuilding permit 2SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ✓Not Applicable
Name:
MORTGAGE COMPANY:
Name:
I/Not Applicable
Address:
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: i/Not Applicable
Name:
BONDING COMPANY:
Name:
4,�NotApplicable
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.
1 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, 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.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before.commenciniz work or recording vour Notice of Commencement.
Signature 61 ner/ Lessee/Contractor as Agent for owner
%Wlirfer,15f Contractor Icense Ho er
STATE OF FLORIDA
COUNTY OF F,LO12/Do+
STATE OF FLORID
COUNTY OF
SW9rn to (or affirmed) and subscribed before me of
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Sworn to (or affirmed) and subscribed before me of
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9" Physical Presence or Online Notarization
this dayof_Feb Dal
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Name of person making statement.
Name of person making statement.
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Personally Known OR Produced Identification
Personally Known OR Produced Identification DC
Type of Identifi ation
Type of Identification
P duced L C/LENNIFER J. BULTEN
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NOTARY PUBLIC
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(Signature otary Pu Ic- $tie of�glr O@l State of Florida
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Commission No.
Commission No.
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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DATE
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COMPLETED
Rev. 5/b/zu