HomeMy WebLinkAboutBuilding Permit AppI SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATICIANOW ,
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:
Name:_
Address:
City:_
Zip: _
x Not Applicable BONDING COMPANY: X Not Applicable
Name:
Address:
Phone: I 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, s pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNIN OWNER: Yo ord a Notice of Commence may result in a in twice for
i ovements to r rope . A No 'ce of Commencem must be rec i I t�eg_ u ecords of St.
ucie County st onthe Iobsite efore the first' pection. If y Y nt d tgobth obtain ffinanc 91
consult
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Si re of Owner see/Contractor as Agent for Owner
Sign ure of ContracteffEtclTilise Holder
STATE OF FLORIDA
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STATE OF FLORIDA f, ,
COUNTY OF �pz
COUNTY OF
Swgrh to (or affirmed) and subscribed before me of
Swor o (or affirmed) and subscribed before me of
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thi day of 20 by
l Pr nce or Online Notarization
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N o erson making s atement.
Nammaking sta ment.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced eF1 INDA DARDEN
Pro NDA DARDEN
f • r Notary Public State of
?�4•F,. Notary Public State of Florida
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Commission # HH 214338
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(Signature of Notary P blic- t {fit �4M6 oral Notary Assn.
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. S/b/ZU