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HomeMy WebLinkAboutBuilding Permit App Pg2SUPPLEMENTAL GONSTRUCTIC}N LIEN LAW INF©RfitIATION� DESIGNER/ENGINEER: x— Not Applicable MORTGAGE COMPANY: x— Not Applicable Name: Seaside Engineers/Edward Roske Name: Address: 4265 soth ct Address: City: Vero Beach State: FL City: State: Zip, 32967 Phone 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. 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, 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 commencing work or recording our Notice of Commencement. G".1, Signature of Own r/ Les e/Contractor as Agent for Owner Signature of Con actoi` icense Holder STATE OF FLORIDA STATE OF FLORIDAt COUNTY OF Martin COUNTY OF Manln Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of x Physical Prewgice or _Online Notarization this Z day of 202Uy x Physical Presence or nline Notarization this � day of 202&by si.I Jonathan Starrett 1 V�— Jonathan Starrett Name of person making statement. Name of person making statement. Personally Known x OR Produced Identification Personally Known x OR Produced Identification Type of Identification Type of Identification Produ d Produc d (Signature of Ndt4ry Public- Slqtemsq i ature of Ndary Public- t t f I i g Y r�, Notary Public State of Flori Commission No. GG235102 'r. (So * -!a Staples is GG235102 +ray °"°• n tar ' Ibllc Mate of Fiotid Co fission Nooil,(( Commi3slon GG �'-i1 071041„ 022. 1 tnlr j tiny (r i,n r,G 2'51r' ) & REVIEWS FRONT `"'q, W^., f'Y;'•.> ZONING Lx ✓`Sy+ .. SUPERVISOR PLANS VEGETATION T.. , ,w+s pr'h..,M1p'Y� SEA TURTLE ;y"'4„ P}..;.kr'"ie d'"aF sMs. MANGROVE N, COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.