HomeMy WebLinkAboutBuilding Application2SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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Name: Specialty Engineering-Gonsultants Inc.
Addr s: w venue
City. O St�te:
Zip: Phone 44
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Address:
City:
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 Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is 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.
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 exemptfrom 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 tbepublic records of St.
Lucie County and posted on the jobsite before the first in pection. If you intend to t n financing, consult
with nder or an attorne before commencin wor r4cording your Notice of C m encem nt.
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Signature f Owner/ Lessee/Contractor as Age f caner
nature of Contractor/License H der
STATE OF IL
STATE STATE OF FL��BWARD
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COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this Z, day of PL GpVZ Z; t 2021 by
Physical Pre nce or Online Notarization
this day of 2029 by
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SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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