HomeMy WebLinkAboutBuilding Permit Application (2) RECER D JAN 131016
�;ENlENTAL CONSTRU,('-7- LIEN.LAW.!N_FORMATIpN
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name:' Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _YNotApplicable BONDING COMPANY: — otApplicable
Name: Name;
Address: Add cess:
City: City:
Zip: Phone: Zip: Phone:
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 mayrestrict 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,l 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 the first inspection.If you intend to obtain financing,consult with fender or an attorney before
commencing work or recording our Notice of Commencement.
_Signature of Owner/Lessee/Agent Signature of Contractor/License Ho der
STATE OF FLORIDA STATE.OF FLORIDA
COUNTY OF COUNTY OF L..u{'4-oj,
Thefor oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ZI day of;OWAwr , 20 d--by this j8tnday of bd�Wn ,2015 by
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(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of FloridaiLA) \l\tilllliilf/f/�
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