HomeMy WebLinkAboutbuilding permit'SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER9
:
Name:
Address:
City:
Zip: Phone,.
Name:
Address:
City: State:
Zip: Phone:
Not Applicable � BONDING COMPANY: _Not Applicable
Name:
Address:
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Zip: Phone..
OWNER/ CONTRACTOR AFFIDVIT.9, 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 i r... granting a permit will authorize the permit holder to build the subject structure
which i-q in contlict 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 a ,
WARNING I
n paying twice for
provements to your properiy._ FuANcments to your
n OWNERvccessorv
Your failure to Record a Notice of Commencement uses to another non-residential use
ocr
esult i
tibheb tiaeolic records of St.
Lucie County and Hosted on the ibefore the first inspection. If you intend to obtain financing, consult
with lender or an attorne before commencin work or recordinyour Notice of Commencement.
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Signature.., Owner/ Lessee/Contractor as Agent for Owner Sign'a ure of Contractor/License Holder
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STATE OF FLORIDA � STATE OF FLORIDA `}
COUNTY OF S-� . I�LIC 1-e. COUNTY OF
SwoSwot'o (or affirmed) and subscribed before me of Sworn;
or affirmed) and subscribed before me of
Physical Presence or Online Notarization hVS
ical Presence or Online Notarization
this �_ day of � Y'UCt�� , 202� by this �, day of � - 2026 by
J afY� �. � �oA��
Name of person making statement. Name of person making sta ment.
Personally Known � OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
KIP lliiiimp
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(Signatur'' f Notar - (Signature%f Notary Publio"
"ey Notary Public State of Rorida �u�' "y6 Not Pup�is State of Florida
Commission No. j �' Margaret �E�1Q�pare Commission No. � Nia�E Montepare
;, � My Commissan GG 214990 ���11 t. My Commission GG 214990
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/b/zu