HomeMy WebLinkAboutPermit Application 2SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: _ 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:
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 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
commencing work or recording your Notice of Commencement.
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s
ature of Owner/ Lessee/Agent Si , ure of Contractor/License Holder
STATE OF FLORIDA. STATE OF FLORIDA ,
COUNTY OF 34 1/6-C COUNTY OF :�_ mac P t
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 5z-� � L/ 20 (, by this day of �. 20_J 7 by
(Name of p4rson acknowledging) (Name of p rson acknowledging)
/%" /110� J U tl ! L2t
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Pap -L--4 - _ _ - Type of Identification Produced
MULE MARTIN
Commission No. V N"Ifti is -still of FWNI Commission No.
• Ca"Ssion # FF 216951
MY Comm. Expires Apr 5, 2019
t#OIINdlllMUM KationaI NWNarr Aft
Revised 07/15/20
_
'MIKE MARTIN
OWle • Ste* al FUdO
CowlisIon 0 FF 216951
Natie w Ndn Asan.
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