HomeMy WebLinkAboutGARY GLARDON 2 AC'S IN ONE HOUSE APPLICATION (2)SUPPLEMENTAL CONSTRUCTION LIEN LADY INFORMATION:
I ucJt%3iVCK/CIVt7INht:K; Not Applicable
I Name: _
Address:
1 City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address: --
City:
Zip' , Phone:
MORTGAGE COMPANY
Name-,
Address: City-
Zip- Phone:
BONDING COMPANY,
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
Not Applicable
OWNER/ CONTRACTOR AFFIDVli: 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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consul twith your Homeowners 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 attorne b fore commencing work or recordingAour Notice of Commencement.
Signature of Owner/ C ssee/Contractor as Agent for Owner
STATE OF PI`ORi A R
COUNTY OF_ �_ kC.'� __-
Sworn to (or affirmedl and subscribed before me of
this )l� day of 0bL-t , . 20 72:Ji by
Name of persoi`making statement.
Personally known X OR Produced Identification
Type of Identification Produced,
of Notary Public -
of Florida)
Commission No, 9Seal)
REVIEWS FRONT ZONING
j COUNTER REVIEW
f DATE }
RECEIVED
j DATE
1 COMPLETED
Rev 20771-
_
5 M .2 :2
Physical Presence or Online Notarization y
�o
JANICEGERROW
*: my COMMISSION#� GG 259744
EXPIRES: September IS, 2022
•�.OFF��'� 80r4ed Thrui 0fWPUb0CUndet brs
SUPERVISOR ; PLANS
VEGETATION
SEA TURTLE MANGROVE
REVIEW REVIEW_
REVIEW
REVIEW REVIEW f
NOTICE OF COMMENCEMENT
To be completed when construction value exceeds $2,500.00 (Recorded copy needs to be submitted to the permitting office)
PERMIT#: TAX FOLIO#_q5 f oC>C�',5
STATE OF FLORIDA
The undersigned herebygives notice thatimprovement will be madeto certain real property, and in accordance with Chapter713, Florida
Statutes, the following information is provided in this Notice of Commencement.
LEGAL DESCRIPTION OF PROPERTY (AND STREET ADDRESS, IF AVAILABLE):
GENERAL DESCRIPTION OF IMPROVEMENT:
OWNER INFORMATION OR LESS E INFORMATION, IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name:
Address: u X3 2 l 9
Interest in property:[]
Name and address offee simple titleholder (If different from Owner listed above):
CONTRACTOR'S NAM
Address:
SURETY COMPANY (If applicable, a copy of the payment bond is attached):
Name and address:
Phone No.:
LENDER'S NAME:
Address:
Bonda
No.:
Persons within the State of Florida designated by owner upon whom notices or other documents may be served as provided by Section 713,13
(1) (a) 7, Florida Statutes:
- "- Phone No.:
Address:
In addition to himself or herself, owner designates
receive a copy ofthe Lienor's Notice as provided in Section 713.13(1)(b), Florida Statues.
Phone numberofperson or entity designated by Owner:
Expiration date of Notice of Commencement:
(the expiration date may not be before the completion ofconstruction and final payment to the contractor, but will be 1 yearfrom the date of
recording unless a different date is specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713 PART I SECTION 713.13 FLORIDA STATUTES AND CAN RESULT IN YOUR PAYING TWICE FOR
I PROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR
RECORDING YOUR NOTICE OF COMMENCEMENT.
I have re!$the foregoing and thatthe facts in it are true to the bestof my knowledge and belief.
Officer/Director/Partner/Manager/Attorney-in-fact
SigLiat s Title/Office ,/
The foregoing instrument was acknowledged before me by meansof � physical presence or online notarization, this�,7 day of 202�
By:S�CC� �1�F1(bJJ as for
Name o person Type ofauthority
♦ ��
(Print, Type, or Stamp Commissioned Name of Notary)
AD
Name of party on behalf of whom instrumentwas
executed (e.g. officer, trustee, attorney -in -fact)
Personally knowr r&roducedidentification ❑
Type of identification produced
A Accesslblllty Dlsclo era Statement _ This document may be reproduced upon request in an
alternative format by contacting the County ADA Coordinator (772) 320-3131, the County
Administration Office (772) 288-5400, Florida Relay 711, or by completing our accessibility feedback
form at www.martin.fl. c/accessibility-fe rih�rk,
Rev. 06-21