HomeMy WebLinkAboutBuilding PermitSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DE5I6NER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name:co ,e,.,enaomen uc Name:
Address: Rare Fedei lwP Address:
City: Pen� State: n. City: State:
Zip:_ Phonel3++I413M03 Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: 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 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.
Inconsideration 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 beforr� the first inspection. If you intend to obtain financing, nsult
with lender.or an attorney before coromenafng work or recording your Notice ofFommencemmlt.
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Signal r f O ne ssee/Contrac r as s-A t for Owner
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Signature f Con acts
nse Holder
STATE OF LORIDA
COUNTYOF
STATE OF FLORIDA
COUNTYOF
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Sworn to (or affirmed) and subscribed before me of
Physical Presen �eo�[n Online Notarization
Sw rn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of/ 2024 by
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Name of person makin statement.
Name of pers in making statement.
Personally Known q OR Produced Identification _
Personally Known x
OR Produced Identification
Type of Identification
Type of Identification
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(Signature o otary i - State of Florida I
Commission No. / jlz< 3 (Seal)
(Signature of N ary
Commission No. 2
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/b/ZD