HomeMy WebLinkAboutBuilding Permit Application (2)SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ___ Not Applicable
Name: ______________________________________
Address:_____________________________________
City: _____________________________ State: _____
Zip: ___________ Phone: _______________________
MORTGAGE COMPANY: ___ Not Applicable
Name: ______________________________________
Address: ____________________________________
City: _____________________________State: _____
Zip: __________ Phone: ________________________
FEE SIMPLE TITLE HOLDER: ___ Not Applicable
Name: ______________________________________ Address: ____________________________________ City: ________________________________________ Zip: ___________ Phone: _______________________
BONDING COMPANY: ___Not Applicable
Name: __________________________________________
Address: ________________________________________
City:____________________________________________
Zip: ___________ Phone: ___________________________
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, 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 posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording your Notice of Commencement.
_________________________________________
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA COUNTY OF_________________________________
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known _______ OR Produced Identification ______
Type of Identification Produced__________________________
Commission No. ______________ (Seal)
__________________________________________s
Signature of Contractor/License Holder
STATE OF FLORIDA COUNTY OF___________________________________
The forgoing instrument was acknowledged before me
____ bythis ____ day of _________________, 20
____________________________________________________
(Name of person acknowledging )
____________________________________________________
(Signature of Notary Public- State of Florida )
Personally Known _______ OR Produced Identification _______
Type of Identification Produced___________________________
Commission No. ______________ (Seal)
REVIEWS FRONT
COUNTER ZONING
REVIEW SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS
Revised 07/15/2014
The forgoing instrument was acknowledged before me
this ____ day of _________________, 20 ___by
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ST LUCIE INDIAN RIVER
16th November
William M. Sunkel Jishua Farrow
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HH044021 HH044021
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