HomeMy WebLinkAboutbuidling permitSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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,
certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is a grantingpermit will authorize the permit holder to build the subject structure
which conflicts with any applicable Homeowners Associaion 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.
Lucie County and posted on the }obsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
•., SHELLI LESTER ROSS
`;:'
- State of Florida -Notary Public
Signature of Contractor - or - Owner Builder as applicable Commission N GG 194634
My Commission Expires
STATE OF FLORIDA cI March 11. 2022
COUNTY OF
Swo (or affir d) and subscribed bef me of _ Physical Presence or Online Notarization
this day of 20�y
Name of person making sta ent.
Personally Known OR Produced Identification
Type of Identification Produced
LL; 111 4D 4L
(Signature of Notary Public- State of Florida)
Commission No. (Seal)
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Rev 10/12/21