HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number
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SIPPLEMEIVTAL CQNSTRU ION LIENsI AW IN1=C3RMATION;�'
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DESIGNER/ENGINEER: _ Not Applicable
Name: Tilteco Inc.
MORTGAGE COMPANY:
Name:
x Not Applicable
Address: 6355 NW 36th St Suite 305
Address:
City:
Zip: Phone:
State:
City: Virginia Gardens State: FL
Zip: 33166 Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY:
Name:
Address:
City:
_Not Applicable
Address:
City:
Zip: Phone:
Zip: Phone:
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 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded 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 recording vour Notice of Commencement.
Signature of Owner Lessee/Contractor Vor Owner
STATE OF FLORIDA
COUNTY OF St. Lucie
The fpr oing instru��ent was acknowledged before me
this day of .J(n y')p 20by
Michael Heissen4g
(Name of person acknowledging)
�Y"Ny' 0
I�
(Signature of Notary Public- State of Florida )
s
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF St. Lucie
The forgoing instrument was acknowledged before me
this day of l_ b a 20_2�_ by
Michael Heissenberg
(Name of person acknowledging)
&PA4A n' a�
(Signature of Notary Public- State of Florida )
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission 401� qQ jAR sso� NOTARY PUB I�ommission No. !� ( gsso Shanon O';
a , NOTARY PI
—STATE OF FLORIDA
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Revised 07/15/2014 Expires 9/12/2022 iExpires 9/1
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