HomeMy WebLinkAboutBUILDING PERMIT APPLICATION.-
. '"" ·-
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER /ENGINEER: _ Not Applicable MORTGAGE COMPANY:
Not Applicable -
Name : Name :
Address : Address : State :_
C i ty : State : City :
Zip : --Phone : Phone Zip :
FEE SIMPLE TITLE HOLDER: BONDING COMPANY: Not Appl icable
_ Not Applicable -
Name : Name :
Address : Address :
City: City :
Zip : Phone : Zip : Phone :
'n icated .
0 , d h k and 1nstallat1on as I d WNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to o t e wor
I ce rtify that no work or installa tion has commenced prior to the issuance of a perm it .
. , h Ider to build the subject structure St. Luc ie Countx makes no representat ion that is granting a perm it wi ll author ize th e permit o th t av restrict or prohibi t such
wh ic h is in co n lic t with any ap plic able Hom e Owners As _soc 1a11on ru le~. bylaws or and co vena nts . ? m h" h m apply .
st ruc ture . Please consul t with your Home Own ers Assoc1at1on and review your deed for any re stric t ions w IC av
In cons ideration of the grant ing of this requested permit , I do hereby agree that I will, i n all respects, perform the work
i n accordance with the approved plans , the Florida Building Codes and St . Lucie County Amendments .
The following building perm it appl ications are exempt from undergoing a lull concurrency review : room add it ions ,
accessory structures, swimming pools, fences, walls, signs , screen rooms and accessory us es 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 attorne before commencin work or record i n our Noti ce of Commencement.
Agent for Own er
STATE OF FLOR_IQA t· "
COUNTY OF Mtlf (• 1 --'-'-'----'-'---'----------
Sworn 1_2~or affir!'"ed) and subscribed before me of
th is _15_' day o~ llr , 20.M_ by 0. [) o.J,4, .
otary ublic -Stale of Florida )
r:..~ I '(JJJ1
I c~mi,.ioo "_-_Vl ____ .-___ (_Se_a_l) ___ _
I REVIEWS ' FRONT
COUNTER
ZONING
I REV IE W
SUPERV ISOR
REV IEW
Phy sica l Presence or __ On line Notari zation
PLANS
REVIE W
l~IIV, "· GONULEZ ;i Hollry Public· Stitt cf ~londl
CommlnlonfGG 197l18
....... · My Comm. Explro, M,lr 11, 2022
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW