HomeMy WebLinkAboutJanero AC Change out permit app pg 2SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: ---City: State: ---
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOlDER: _ Not Applicable 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 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 apphcable Homeowners Association rules. bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners Association and reVtew your deed for any restrictio ns 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 anothe r 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 attome before commencin work or recordin our Notice of Commencement.
Signature of Owner/ lessee/Contractor as Agent for Owner
STATE OF RORIDA <:-L J 11 r;
COUNTYOF ___ J{_·._l,.(,\lJ-'-~----
%hysical Presence or __ Online Notarization Sworn to (or affirmed) and subscribed before me of
this ~ day of 'la,t, 11 JLq,,....--• 20'2-Z-by
M,1c1a,,1 C ~l,
Name of person making ~ment.
Personally Known ✓ OR Produced Identification
Type of Identification Produced._~---------
REVIEWS
DATE
RECEIVED
atl!-of Flori
GG 9!'4101
•,.,. o, f\:.,· My Comm. Explrts Aua 21, 2024.
" Bonded through N1tion1I Notary Asll'I.
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PlANS
REVIEW
VEGETATION
REVIEW
SEATURllE
REVIEW
MANGROVE
REVIEW