HomeMy WebLinkAboutRUTHERFORD PERMIT 2... . ..........
SUPPLEMENTAL. CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER,, Not Applicable MORTGAGE COMPANY; Not Applicable
Name. Name:
Address: Address:
City: State: City:RON State:
Zi..
p: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDERV Not Applicable BANDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zia: Phone: .�,.. Zip: Phone:
OWNER/ CONTRACTOR AFFIDVITO: Application is hereby made to obtain a hermit to coo the work and installation as indicated.
certify that no worts or installation has commenced prior to the issuance of a permit.
t, Lucie Coup ,makes no representation that i granting a permit will authorize the permit holder to build the subject t structure
which I 'in conflict with any applicable Haas ner Associationbylaws• �
rules,or and �o�rrrar�t that � re or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
co nsideration of the gra nt! ng of this thi's req nested parr it, I do hereby agree that I will* in a I I respects., perf r the worl
in accordance with the approved plans, the FloridaBuilding Codes and St. Lucre County Amendments.
The following building permit applications are
exempt from undergoing a full
concurrency review: morn
addition
accessory structures, swimming
pools, fences,
walls, signs, screen rooms and
accessory uses to another
non-residential use
WARNING TO GINNER: 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 fasted 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.
5igria,turelQf Owner/ Lessee/Con-tractor as Agent for owner
STATE OF FLORIDA
COUNTY OFI�C.�-2,
Sworn to (or affirmed) and subscribed before me of
this 1$ day of 202 [ by
E:
Name of person making statement,
Personally Known OR Produced Identification
Type of Identification Produced
�ysical Presence or
(Signature of Notary Pubiic- State of Florida � �A&AOL
Commission No. _ �aAqRq-L (Seal)
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Online Notarization
Notary Pubk State of Florid
Margaret E Montepare
y Commission GG 214990
Expires 06/0512022
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