HomeMy WebLinkAboutBuilding Permit Application #2 - Mark Swartz - Wiindmill Lot 88SUPPLEMENTAL CONSTRUCTIONLIEN LAW WFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
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: 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 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.
Lucie County nd postd on the jobsite before the first inspection. If you intend to obtain financing, consult
with lenderran at)ney before commencing work or recording your Notice of Commencement.
Signature Owner essee/Contr ctor as Agent for Owner Signature of Contra /License Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF �:?J. C 1---..,,_._ COUNTY OF L. cfi-e_
S,w9rn to (or affirmed) and subscribed before me of S o n to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
#his day of _ �E 202 J by is day of Jlj�)C 202# by
Name of person making statement. Name of person making statement_
Personally'Known OR Produced Identifications Personally Known OR Produced Identificati�`
Type of Ideptifitcation Type of Ide tification
Produce Produced
(Sig a r f i Publi NAJQWa } (Signs r�, o, ary
=� * MY CO 1SSION # GG 9144D0 '= I GMNON
Cam issi c`: EXPIRES: January 1B, �1}*? MY COMMISSION # GG 91440� I}
Bonded 7M� Notary Public Undemiters Comm'i
• "us2;o� 18.2024
Bonded ihru Notary Pubtio Uwemftra
REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
SUPERVISOR
� PLANS REVIEW I VEGETATION I S REVIEW I MANGROVE