HomeMy WebLinkAboutBUILDING PERMIT APPSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name: Paul Welch
Name:
Address: 1984 SW Biltmore St 114
Address:
City- Port5t Lucie State: FL
City: State:
Zip: 34984 Phone (772) 785-9M8
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.
certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is santin a permit will authorize the permit holder to build the subject structure
which conflicts with any applicable Homeownersssocia ion rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with 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 OWN ER: 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 n the jobsite before the first inspection. If you intend to obtain financing, consult
with le der or an at r before commencing work or recording our Notice of Commencement.
Sign ure of Ca ctor - or - Owner Builder as applicable
S ATE OF FLORIDA
UNTY OF Broward
Sworn to (or affirmed) and subscribed before me of X
Physical Presence or Online Notarization
this24thday of January 12022 by
Marcio SIIva
Name of person making statement.
Personally Kn wn x OR Produced Identification
Type of I ion oduced
J�!KaTi ffe a otary Publi a lorida)
r ' •
Commission Na. Seal)
HUDSON LOPES
3AYCOI�I�dISS*N 9 HEa
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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