HomeMy WebLinkAboutWalton app, 2105-0219SUPPLEMENTAL CONSTRUciloN LIEN LAW IN FORMATloN:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:Name:
Address:Address:
City:State:City: State:
Zip:Phc)ne Zip: Phone:
FEE slfvIPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name:WynnoBUHdingcorp Name:
Address : 128o4 sw 1 22 Ave Address:
City:ManiZip:33186 City:
phone:305€7ac927 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.
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ln 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 Build-ing 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, wal!s, signs, screen rooms and accessory uses to ancther non-residential use
WARNING TO OWNER. Your failure to Record a Notice of Commencement may result .vvAr`Iviivv [u uvvivEr`: yoLir Taiiure to r{ecora a NO{Ice OT lommencement may resu lt ln Payln8 twIC eTor
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ic records of St,nancing,consultement.
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Name of perso-n making statement.Name cTf person making statement.
Personally Known 'tr'OR produced ldentification Personally Known jL OR Produced Identification
Type of Identification Type of IdentificationPro,d*?7,.,7,,i,~+rf Z+ %Z-;~ProducedchLLAan±)-rsig~rfe'ture of Notary PLjb'ric- State of _F:lo[id (Si8na f tarv publir:-State afJ=ln[itla \
Commission N R356204,2023
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DATERECEIVED
DATECOMPLETED
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