HomeMy WebLinkAboutBuilding Permit ApplicationSU'PPLEME"NTAL CONSTRUCTION LIEN, LAW)MFORMATION::
DESIGNER/ENGINEER: Not Applicable MORTGAGE COM ANY• Not Applicable
Name: (`� Name:
Address:. Address:
city:jUM) State: City: (State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone-
plicable .
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.l.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 your paying .twice for
improvements to yo roperty: A Notice of Commencement must be recorded and posted on the jobsite
before the first ir4ectNn. If you intend to obtain financing, consult with -lender or an attorney before
commencing w rk or re ordini; vour'Notice of Commencement.
'bignature ot'uw esse ntractor as Agent for Owner Signature of Co tractor/License Holder
STATE OF FLORIDA STATE OF: FLORIDA
COUNTY OF Indian River COUNTY OF Indian River
The forgoing instrument wfis acknowlecigop efore me The for oing instrument was acknowledged before me
this day of i�- 20 by this �` day of 20 by
(Name. of, pqrson acknowledging). (Name of pi
(Signature of Notary Pu I
ic- t e_' f Florida ) (Signatu
%-
I acknowledging )
.. , 1A A
ifary Pgblic-State of Florida )
Personally Known OR Prod Identification Personally Known _
Type of Identification Produced Type of Identification
Commission No. (Seal) Commission No.
man -•----
ReVis ARY PUBLIC
OF FLORIDA
...,..A.
OR Produced Identification .
Craig a MeoYcC
IdOTARI LIC
STATE OF FLORIDA
.Expires &28=20
'
REVIEWS
5
FFiC11V
12020
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
i
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
I