HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNE
Name: _
Address:
City:
Zip:
INEER. . Not Applicable MORTGAGE COMPANY:
Phan
FEE SIMPLE TITLE HOLDER
Name:
Address:
City:
Zip: Phone:
State.
Not Applicable
Name:
Address:
City:
Zip; Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip; Phone:
Not Applicable
State:
Not Applicable
OWNER CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 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 applicable Homeowners Association 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 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.
��.uu��ie County a osted an the jobsite before the first inspection. If you intend to obtain financing, consult
, wAh lender or n�ttorne before commencin work or recordin our Notice of Commencement.
qSATE
ore of Con ctor - or'- Owner Builder as applicable
OF FLORIDA
COUNTY OF ST LUCIE
Sworn to (or affirmed) and subscribed before me of X Physical Presence or Online Notarization
this �hday of k j�i't.l(;i r-O 2022 by
Name of person making statement.
Personally Known X OR Produced identification
Type of dentification Produced
r
(Signature of Notaa Public- State of Florida)
Commission No. GG 946316 (Seal)
toe
tate of FloridaSirni8GG3tbany
aza
EVIEWS
FRONT
ZONING
SUPERVI!
[RA!E
COUNTER
REVIEW
REVIE\A
RECEIVED
DATE
COMPLETED
ev 1 1
ICR REVIEW VEGETATIEVIEWON SE EV EWLE MR IV EWVE