HomeMy WebLinkAboutBUILDING PERMIT APP (2)UPPLEMENTAL CO ON LIEN LAW INFORMATIO.
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x 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 is in conflict with any applicable Home Owners Association rules, bylaws or and 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
WARNIN OWNER: Yoyvfat re o rd a Notice of Commenc nt may resul ' ingtvvkefe
im vements to r property. A No ice of Commence t must be r ed the public reco s of St.
cie County sted on the jobsi before the first • spection. If u int t obt in financing consult
ith lende n ttor bef mencin wor r recordi ur ice men
re of Owner/ L aibtractor as Agent for Owner
Igna re of Contractor I nse Holder
STATE OF FLORIDA
STATE OF FLORIDA.�
COUNTY OF ���/
COUNTY OF
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produced Bonded through National Notary Assn.
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
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