HomeMy WebLinkAboutapplication 2SLIPPLEMENTAL CONSTRUCTION LIEN LAW
0 1 N;6NIER1, LNGINL I R:
IN11'ORMATION',
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FEE SIMPLE TITLE IHOL ER:
Name: "t "01 Not Applicable
Address: e
City:
Phone
one
MORTGAGE COMPANY
BONDING CqVPANY:
name --
Address
Phone
OWNER/ CONTRACTOR AFFIDVIT: Applicati
11 's hereby rnade to obta,n a permit to do tl-e work and tnsza
ce-tif'y that no wormer installation has Commenced Prior to the issuance of a permit
;-
St. Ll-c c�'E�,Countv makes rOrepresentation that is krant-ng a permit will authorize the Permit holder to build d-,e s�blect
w conflicts WV) an Please
con ul�taPpilcable Homeowners structure, 's with Your Homeowners 'XssOci2tion rules bylaws or and covenants that may rest,ict or Pro-l"Holt
In consideration Of the granting k�sOclatlon your deed for any restrictions winch ra,, .3ppiv
in accordance with the a anting of this requested permit I do hereby agree that I will in all reqPEC-S 0ErtC,-`1 -te Ncr',(
approved plans, the Florida Suild�ng 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 accessary uses to another non-restapnz4 aj use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
W �PrO"'ents tnO your Property. A Notice Of Commencement must be recorded in the Public records of
Lucie
C my
with
le de poste -st inspection. If you intend to obtain financirig,
fe jobsite before the F
attc ef ore commencing work or recording your Notice Of Commencement.
')igna of Owner/ Lesse �,oni�
;rEOF FLORIDA
COUNTY OF
Sworn to (or affird) and subscribed befor me of ----KPJinysical Presence or Online NOtanzaton
1 -2 this day of 20 by
Name of person making statement.
I
Personally Known XOR Produced identification
Type of Identification Produced
(Signature of Notary PdWlic- Sfate of
,pr 't,�' Notary Public Ste* of �-1wcia
4P Ashley Manchester
My Commission HH 017384
� 4.5 ExpiiVs 07 , 10 A a'024
Commission No (Seal)
REVIEWS i FRONT ZONING i SUPERVISOR 1 PLANS j VEGETATION SEATURTLE
COUNTER REVIEW i, REVIEW REVIEW I REVIEW REVIEW
DATE
RECEIVED
DATE - --
COMPLETED
MANCRIOVE
REVIEW