HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name: Flonda Engineering
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: 44516 Tamiaml Trail Ste #B14
Address:
City: PWChadotte
Zip: 33980 Phone
State: FL
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address: PO BOX 776
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 Aapplyo,
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the LFor -9
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 usEPp
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 the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
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lgnature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
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STATE OF FLORIDA
COUNTY OF c I'LACit
COUNTY OF Bred ono
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The forgoing instrument was acknowledged before me
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this _C day of 5el2feMlgef201$ by
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Name of person making statement
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Name of persF makirkh statement
Personally Known OR Produced Identification
Personally Known V OR Produced Identification
Type of Identification
Type of Identification
Produced RL WV.Pt'S License
Produced
NOTARnY PU
ISignature of Notary Public -State of FIovs/.:v
I�Signatur of Notary Public -State of Florida j
nSTATE OF FL
Commission No. a3 /�� I
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLAN
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVI
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.g/2/17