HomeMy WebLinkAboutTed Weise Permit Application Pg 2SUPPLEMENTAffCONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER& _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address: State:
citys State:. City:-
Zip: Phone Zip: Phone...
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY*" Not Applicable
NameName:
Address: Address:.
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDViTee Application is hereby made to obtain a pe it
1 certify that no work or installation has commenced prior to the issuance of a permit.
to do the work and installation as 'indicated.
St., Lucie Countymakes no representation fihat is �gran�ting a pe�rnit wilt autharize the ermit holder to build the subject structure
which is in conflict with any appti�abte Home Owners Assoc[a�ion r�l,�s, bylaws or an�cavenants that may restrict or prhibi# such
structure. Please consult srv3th your Home Owners Associafion and review your deed for any restrictions which Y pply.
In consideration of the grantingof this requested pe it, I do hereby agree that I will,in all respects, perform the work
in aecordance with the approved Plans, the Florida Building bodes and St. Lucie County Amendments*
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessary structures, swimming pools, fences, walls, sins, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure tRecord a Notice of Commer�cement may resr�lt 1n paying twice for
improvements to your property.'A Notice of Commencement must be recorded in the public records of St,
Luc"e County and pasted on the �dbsit� before the first �nspectian. if you intend to obtain financ�Mg, consult
with lender or attorne before commencin v�rc�r�c or recar " Our vti ommencement
�t�jin'afu'-re of owner]
STATE OF FLORIDA
COUNTY OF .9
or as Agent for Owner
Swom to (or affirmed) and subscribed before me of
�hysical Presence or Online Notarization
this L day of 2Q?4 by .A�
Name of person making 5tatem'ent.
Personally Known V00-0*
Tyke of Identification
Produced
(Signature of Notary
Commiseton No..
A97b5'9
REVIEWS
RATE
RECEIVED
DATE
COMPLETED
�V.m
OR Produced Identification
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*,* Y * '#, SAVANNAVILLWEU
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• - MYCONION#GO 197669
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FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
Signature of Contra
STATE OF FLORIDA
COUNTY OF
/Ci0ft'eHolder
sw7on to (Qr affirmed) and subscribed before mePhysical Presence or. . Online Notatization
th"" is ji day of r 20�D by
it
dame of person making statement.
personally Known Leo�OR Produced Identification
Type of Identification
Produced
r I (Signature of Notary Public- S
Commission N.
PLANS
REVIEW
VEGETATION
REVIEW
a-
da SAVANNASTILLWEL
4
MY COMMISSION # GG I
-�l)(IS', Match 1 , 2(
Bonded Thru Notary Public Und
-
SEA TURTLE
REVIEW
MANGROVE
REVIEW
7