HomeMy WebLinkAboutBUILDING PERMIT APP (2)- PLEASE HAVE THE CONTRACTOR SIGN, RESEND NEW PAGESUPPLEMENTAL CONSTRUCTION LIEN
LAW INFORMAT%i0N,',:
DESIGNER/ENGINEER: _Not Applicable
MORTGAGE COMPANY: Applicable
Name:
_Not
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip; Phone:
FEE SIMPLE TITLE HOLDER: Not App lica ble
BONDING COMPANY: _Not Applicable
Name:
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 apermit.
St. Lucie Count yy makes no represegtationthat is granting ape rmit will authorize the ermit holder to build the subject structure
which is in contllct with any applicable Home Owners Association rules, bylaws orantl 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
spec
or an attorneybefore commencingwork or our Notice of Commencement,
hl�lender
��with
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDy-1 `
COUNTY OF T h (ACC
Sworn to (or affirmed) nd ubscribed before me of Physical Presence or... Online Notarization
LULL �I
by this _. day of
_, 20
4 1L4Ln W(N -her s
Name of person making statement.
Personally Known OR Produced Identification___
_
Ty
P�� ced__________
,ofldentlficatio
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Signature of Notary ublic-State f F idaj_„_
Commission No. (Seal) ` NolaryPuolicSletedFtorMe
OianeGomez
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