HomeMy WebLinkAboutBUILDING PERMIT APP 2SUPPLEMENTAL CONSTRUCTION LIEN -LAW I.NF-0-R-MATION,
DESIGNER/ENGINEER; _Not Applicable
Name:
Address:
City: State:
Zip: Phone
. . . . . . ................... . ...
FEE SIMPLE TITLE HOLDER:
Name:
Address',
City:
Z*Ipql Phon'e,
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name;
Address:
City: Stake:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
city:
Zip: Phone;
_Not Applicable
OWNER/ CONTRACTOR AFFIDVIT1*1 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.
t. Lucie *County ,makes no representation that i grantingaPemit will authorize tik�ich i � o�� rt ana� ����� ���� t� ���� the subject structure
applicable o Owners latrio � rules, or a 9 o rya nts that prohibit
structure. Please consult with your Home Owners Association and review your deed for any restrictions whichmay apply.
In consideration of the granting f this requested errni � � herb agree
.f that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and
. Lucie CountyAmendments.
The following building permit applications are exempt from undergoing a #ull concurrency review: room additions,
aCCe5SOij1 StruCtIli'E5r SWImmi1"ig pools, fences, walls, signs, screen roams and accessory uses to another non-residential use
WA RN I NG TO OWN E R: 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 an the jobsite before the first inspection, If you intend to obtain financing, consult
F with lender or an attorney be -Fare commencing work or recording.,your Notice of Commencement.
Signature of 0% r] Lessee/contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
r'"
Sworn to (or affirmed) and subscribed before me of �Physlcal Presence or Online Notarization
this day of 20 by ..._.
Name of person making stateflii6nt,
Personally Known "� OR Produced Identifi ation
"
Type of Identification Produced
(SignauYe of 1�Jotary Public- State of Florida y
Commission Na. �Q1 t`A �i�0 (Seal)
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
Notary Public Sate of Florida
Margaret E Montepare
My Commission GG 214990
Expires 06/05/2022
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW