HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONSUPPLEMENTAL CONSTRUCTION
LIEN LAW
INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
_
Address:
City:
Zip:
Phone
State:
City: _State:
Zip: Phone:
FEE SIMPLE TITLE
Name:
HOLDER.
Not Applicable
BONDING COMPANY. Not Applicable
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.
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 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 recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Palm Beach
Sworn to (or affirmed) and subscribed before me of X Physical Presence or Online Notarization
this 1 day of JUIV , 20� by
Name of person making statement.
Per Ily Known X OR Produced Identification
T Pe of entification Produced
(Signatur� of NotarQ Public- State of Florida )
Commission No.
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
(Seal)
FRONT ZONING
COUNTER REVIEW
SUPERVISOR PLANS
REVIEW REVIEW
Notary Public State of Florid
.lannifer V Beams
My Commission NFi 023214
Expires 07/23/2024
VEGETATION SEA TURTLE MANGROVE
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