HomeMy WebLinkAboutBUILDING PERMIT APPLICATION PAGE 2UPPLEMENTAIL CONS ILICMN UEM tAW INFORMATION:
DFWPiERJENiGINFER'
raM4� :
Address: —
City:
?ip. Phone
_ Not Apphcablc
State:
MORTGAGE COMPANY:
Name:
Address: _
City:
Zip: Phone_
Not Applicable
State.: T
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COIh+IpANY: Not A pllcable
Name_ name:
Address: Address:
City; CitV� -
Zip: Phone' Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work anti installation as ind"ted.
I certify that no work or InstaIlatlon has commenced prior to the issuance of a permit,
St- Lucie County makes no representation that is grantin a permit will auttt dze the permit holder to build the subject S#rlr WFt
which conflicts with an app�licable Homeowners Associa�ion rules, �+,�laws or and mvenants that may restrict or prohibit such
structure. Please consult with your Homeowners AS.sociation and review your deed for any restrictlons 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. Lucle County Amendments.
The fallowing building permit applications are exempt from undergoing a full concurrency review- room additions.
accessory 3truCture3. swimming pools, fences, waft, signs, screen rooms and accessory uses to another non-residential uSe
WARNING TO OWNER: Your faljure to Record a Notice of Commencement may rew It in paying twice for
improvements to your property. A Nonce of Commencement must be recorded in the public records of St -
Lucie County and posted on the job site 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.
a
Sign of Contractor- or - er Builder as applicable
STATE OF FL O I A
COUNTYOEM_ JJA( U
Sworn Jo (or affirmed) and subscribed before me of hysical Presence or _---Online Notarltation
thIsdayof U7 13 _ 2OLL by ZLI-Cry
+ l CA
Name of pemn making statement -
Personally Known T OR Pro&co Ide tification` --
Type of I,&mtfta t i c n Produced_ _ �-
Notary Puln ir- State of Florida)
Cornmi551or1 hi a- (SeiIJ
REVIE'AS
RECEIVED
DATE
COMPLETED
' } KYLIE YERA
�u �- wa[�rr W - SLAP ai ;:C�
COMMil W AH T'r442
my Comm, E:prres Dec 21. 2024
COUNTER i REVIEW S REVIEWER RE11t IE I
� REVIEW ON I S REVIEW I MREVIEW
MANGROVE