HomeMy WebLinkAboutB+M 606 S Market Permit BackSUPPLEMENTALCONSTRUCTIQN UEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City:
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/
STATE OF FLORIDA
as Agent for Owner
COUNTY OF S-�L- U C i 2
Sworn to (or affirmed) and subscribed before me of ✓ Physical Presence or Online Notarization
this 3i day of 7Li 14 20 Z ( by
Name cf person making statement.
Personally Known . f OR Produced Identification
Type of Identification Produced
,.;
(Signature of Notary Public- State of Florida )
Commission No. G 6eJ 8 SGt 5 (Seal)
REVIEWS I FRONT ZONING
I COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLET
Notary Public State of Florida
Chris L Woolley
y�� r My Commission GG 185665
�j IVExpires 02126/2022
S REVIEWOR I REVVIIEW (VREV EWON I SE EV EWLE I M EVIEWVE