HomeMy WebLinkAboutBuilding Permit App (2), plz updateDocuSign Envelope ID: 24AOOF89-BFDO-4E8B-8F01-F3415l l F87FB
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERIENGINEER: _ Not Applicable MORTGAGE COMPANY:
Name; MARKHAM SERVICES INC (57216) Name:
Address: 1820 NE JENSEN BEACH BLVD 9685 Address:
City: JENSEN BEACH State: FL City:
—
Zip_ 34957 Phone 954-941-1124 _ Zip: Phone:
BONDING COMPANY: X Not Applicable
FEE SIMPLE TITLE HOLDER
Name:
Address:
Zip: Phone:
x Not Applicable
Name;_
Address:
city:
Zip:
Phone:
x Not Applicable
State:
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 pennit will authorize the permit holder to build the sublectstructure
which is In conflict with any applicable Homeowners 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
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 jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencin work ar record'-f your Notice of Commencement.
Uo uSigned N:
signa az2 rssee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTYOF S-TLueX,.P—
Sworn to (or affirmed) and subscribed before me of
_Physical Presence or Online Notarization
this a.1-day of Dze . � 2021 by
DA v zo PzPj�4
Name of person making statement.
Personally Known
Type of Identification
Produced 0 !—
OR Produced Identification Dl-
5 _�
(Signatuie of N tart' Public- State of Florida )
Commission No.
re of Contractor/License Holder
STATE OF FLORIDA
COUNTYOF
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or`. Online Notarization
This lz day of ; u 0 • 202(Iby
iZC a u--t W6:3nk�
Name of person making statement.
Personally Known !� OR Produced Identification
Type of Identification
Produced '
(Signature of Notary `Public- State of Florida )
(Seal) Commission No.
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW I REVIEW
DATE
RECEIVED I
DATE
COMPLETED
PLANS VEGETATION
REVIEW REVIEW
(Seal)
SEATURTLE MANGROVE
REVIEW REVIEW
i