HomeMy WebLinkAboutBuilding Permit Application (2)SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Nat Applicable
Name:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: x Not Applicable
Name:
Address:
Address:
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 stru4ture
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 the first inspection. if you intend to obtain financing, consult with lender or an attorney before
commencine work or recordinl� vour Notice of Commencement.
_ Signature of Owner/ Lessee/Agent
Signature of Contractor/License Holder
STATE OF FLORIDA ��rr
STATE OF FLORIDA
COUNTY OF 1 L
COUNTY OF
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The forgoing instrum nt was acknowledged before me
this 10'�, day of 20 by
The forgoing instrument was acknowledged before me
thisI�day of 20 (qC by
(Name of person acknowledging)
(Name of person acknowledging)
(Signature of Notaublic- State of Florida)
(Signature of NWP blic- State of Florida)
P, 2rSonal�y Krfown OR Produced Identification
Personally Known OR Produced Identificat'sat1 -
-Type aftdentlfieation. Produced
Type of Identification Produced n
Co_rnmissicrs-No.
Commission No.
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS