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HomeMy WebLinkAboutBritt Permit 3-24-21 2 SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone 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. 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. Lu ' County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult wi h ender or an attorney before commencing wor cording our tice of Commencement. Signa re of Owner/Lesse6yContractor as Agent for Owner Si nature of ContractidK/1-ftense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF St Lucie COUNTY OF STLucie Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of X Physical Presence or Online Notarization X Physical Presence or Online Notarization this 24 day of March 12020 by this 24 day of March 2020 by Robert Thompson Robert Thompson Name of person making statement. Name of person making statement. Personally Known x OR Produced Identification Personally Known x OR Produced Identification Type of Identification Type of Identification Produced Produced_ (Uffat a of Notary Public-State of Florida 11 y Public-State of Florida) GG 302065 vyv No P lic State of Florida GG 302065 Commission No. tom, y�,b t\Je � P Butterfield Commission No. e My Commission GG 302065 =o+►j*°fir o a Public State of Fton o- Ex res 02114I2G23 Melissa l Butterfield osngo- Expi es 02I1412023 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.