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HomeMy WebLinkAboutSUPPLEMENTAL CONSTRUCTION LEIN LAW INFORMATION10 y912018 12:30 ONSHORE ROOFING SPECIALIST (FAY), P.0021002 n:rt�:�rm ..rui?ii Q�!E6?„iur,iFxn 31�: 69781gieB:�!Gili9l4hG"e!tii8�"iai � R? b'�9 '�} 4 ki!�si ;: ; � i �, ; y1;�;� . ,;[I�,,r .. � r -.r „• � . �F dl i i � & n n H.:'.r::d!:.I:.i:. •^.(�y,,-.-s.;�?'91 r.�roien�o �; � 7� gp?m�a 6 yGci _ ;. a r. Y■,.. a�!2�,wy��fC.��'r'�r� a��Is�i; � •,�; e" s! ���y��h •, • i I�,yIA� r i�C�7'.'1314'1,0�10©.iti 7 �, r_- a `' = : i3 •,tea,.., �_ z���F1 ..�inls+@wa_ rye rsC rtssu r,sr, i s ` •rd ,�� ::. rl :.; ._ r 1^ t• •n, :u::`~r�:r�.7eroir_; �e. ; MORTGAGE COMPANY: Ni ;gr -Ap �._ •.. 1 L',�_f-.�s�� Not Applicable DESIGNER/ENGINEER: _ 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: By Zip: Phone: Zip: Phone: St L�Cl � y_ OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certifythat 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 your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before first in ec "on. If you intend to obtain financing, consult with lender or an attorney before commencimwo or r cordinR vour Notice of Commencement. S natur r/ Lessee/Contractor as Agent for owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The f inr s c aTefore me th i �ay o The forgoing instrument was acknowledged before me this _day of 20_ by ( iame of aking statement Name of person making statement Person I nown R P d ed Identification �on Personally Known OR Produced Identification Type o I tificat Type of Identification Prod Produced (Signature of`(J.........ojayblic- Stalitrbf<.E]diiiMgl+%iB (Signature of Notary Public- State of Florida ) .. , < 1. �, n'. (�m _ Notary Publlo - State of Florida ' .y Commissiorf �. r` ." Co mission, n 60_4i427 Commission No. (Seal) OFF My Comm. Expires Mar 3, 2019 REVIEWS FRONT ZONING SUPERVISOR. PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED 8/2/17