HomeMy WebLinkAboutpermit application(2)SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not 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:
City:
Address:
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 thepermit 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 vour Notice of Commencement. P
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF �-lA
The for ing instr n was cknowiedgeefore me
this I day of 20 1 Uby
ic-
1 v,
(Name of person acknowledging )
tl�a�6j �_
(Signature of Notary Public- State of Florida )
Personally Known i/'/ OR Produced identification
Type®fk3ehtification Produced
o+rrntssicrr:No. - (Seal
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c ' Y '0,,A ,SS10N nrri!n e
ise f/1 94 APIRI=S eCember 12, 2017
Qre.,. � °• � CnnJfCZ.COt1'!
STATE OF FLORIDAj o , y� ,
COUNTY OF i `��
The fo�oing inst, um nt w s acknowledged before me
thisi "s day of 20 � by
Ile
(Name of person acknowledging)
(Signature of Notary Public- State of Florida.l
Personally Known t,OR Produced VJerttifiication
Type of Identification Produced
Commissi
SPA" '� • SUZETTE i lT y F1
IviwssI0N #FF064M8.'
EXPIRES December 12, 201f -...-
(407) 09a 0157
53
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
-'
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS