HomeMy WebLinkAboutMARSCH 2SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE BOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
State:
Not Applicable
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 recordine vour Notice of Commencement.
Signature of Owner/ Lessee/Agent Signa of Contractor/License Holder
STATE OF FLORIDA , ,TATE OF FLORIDA
COUNTY OF COUNTY OF �c
The forgoing instru ent was acknowledged before me The forgoing instrum nt was acknowledged before me
this day of 20 qLby this day of ,. 20 by
(Name of person acknowledging) (Name of person acknowledging )
1.r� Jn ,�
t I.ht�V'FnA A i ';7 r r:.
(Signature of Notary Public- State of Florida }
Personally Known Produced Identification
Type of Identification Prod
jLvj_/11
(Signature of Notary Public- State of Florida )
Personally Known �OR Produced Identification
tape of Identification Proid_use�
Commission No. rs1 - S1tle o1 Flor mmission No.
• .� �IN N FF 216851
?_ _ My Cern. Expires Apr 5.24 S
Revised 07/15/2014
NUKE IIIMM
Notes •sure of Flo W
commission a FF 21MI
n , ded through Ntltiarsl Mmy Assn.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS