HomeMy WebLinkAboutWS Lot 3 - BLDG Permit Application - 2ND PAGE SIGNEDSUPPLEMENTAL CONSTRUCTION LIEN LAW
INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone:
State:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
Not Applicable
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.
I 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 ermit 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,
accessary 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MYST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU IN END TOO IN FINANCING, CONSULT
WITH YOUR LENDER OR ATTORNEY BEFORE RECORDING YOUR NQT E OF CO ENCEMENT."
Signature of Own�le
STATE OF FLORIDA
COUNTY OF PALM BEA(
as Agent far Owner
The fo�r$oing fnstrumer t was acknowledged before me
this 5f day of �I,tl� , 20,�v by
KEVIN aaRKENHAGEN
Name of person making statement.
STATE OF Fl
COUNTY OF
BeACH
The for oing instrument was acknowledged before me
thisday of J`gAA�^ 20�by
JOSEPH SPALT
Name of person making statement.
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
nature of Notary Pu611 -; FIgJ'df�a)jpublic-State of Florid ignature of Notary Public- t, �' 'rit�a
• Commission p GG 917671 � •, °
e`
Commission No. GGa1Ts�1 o nd,F' My($@r817 Expires Sep 29, 202 mmission No- GGBt7a71 t r oA' M
Bonded through National Notary Ass . •••••t` o
Bonded t
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
KEVIN WIRTH
Public -State of Ftol
��ppunion # GG 917fi71
Ih. Expires Sep 29, 2
ugh National NOtaiv A
MANGROVE
REVIEW