HomeMy WebLinkAboutHT Brown Larry Hannon permit application 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 TITLEHOLDER. Not Applicable BONDING COMPANY: Not Applicable
Name : Name :
Address : Address :
City: City:
Zip : . . Phone : Zip; Phone :
OWNER/ CONTRACTOR AFFIDVIT,.p Application is hereby made to obtain a permit to do the work and installation as indicated.
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 authorise 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 .
Lucie County and posted on the jobsite before the first inspection , If you intend to obtain Financing, consult
with lender or an attorney before commencing work or rec-ording your Notice of Commencement.
Signature of caner/ Lessee/Contractor as Agentlor Owner Signatu of Contra ctor/Lice n se Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF st Lucie. CO U NTY OF 5t Lucie
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 10 day of June 020 by �h�s 10 day of 2020 by
Robert Thompson Robert Thompson ow
Name of person making statement. Name of person making statement.
Personalty Known X OR Produced Identification � Personally Known X OR Produced Identification
Type of Identification Type of Identification
ProdUC . Produced
1p
(Sign4ture of Notary Publ " 19ignat re of Notary Public- State of Florida }
Notary Pudic Stye of Florida
Commission No. GG 302465 y� �'r Mal(fiail) gutferfield Commission No. GG 302065 Public Site of Florid
My Commission GG 302065 t�s5a L Butter5eld
do-` E,;pires 02114/2023 My Commission GG 302065
es 11417093
REVIEWS FRONT ZONING SU PERVISOR PLANS VEGETATION S EA TURTLE MANGRUV
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATA
COMPLETED
eW. 5/6/2.0