HomeMy WebLinkAboutBuilding Permit application (2)SUPPLEMENTAL. 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: i
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 thepermit holder to build the subject structure
which is in conflict with any applicable home Owners Association rules, bylaws or ansa 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 far
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
commencin&Qrk or recording your Notice of Commencement. J--_
_ Sign re of O ner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this _ day of 20 _--by
qtr r.J C FJ e'_ S sz i
(Name of person acknowledging)
(Signature of Notary Public -'%ate of Florida )
Personally Known V OR Produced Identification
Type of Identification Produced .
se
STATE OF FLORIDA
COUNTY OF ST Luc"
The forgoing instrument was acknowledged before me
this day of
20 by
_ Cr'C Ii
IName of person acknowledging j
{Signature of Notary Public- Stat orida 1
Personally Known � OR Produced Identification
Type of Identification Produced
�.. �' HE THER RI1�IC:i
Commission No. sJoN#FF14as2QCommission
No.EA'
LN
MES: Jnty 10, 2020Fti
E}CFIRES: dull !0, 2020
Revised 07/15/2014
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS