HomeMy WebLinkAboutBuilding Permit Appl. Page 2SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGN ER%ENGINEER: —Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone_
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
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 wc�qr recording your Notice of Commencement.
Signature of Ov6er/Lessee/Contractor as Agent for Owner ! Signature of Contractor% -cense Holder
STATE OF FLORIDA?
COUNTY OF
The for ng instru nt was acknowledged Before me
this.day of l2` 20 b1
(Name a�Fson,acknoVledgi
re of Nrar�,Kublic- State of Florida )
t! �
Personally Known OR Produced Identification
Type of Identification Produced
Commission No_
Revised 47/15/2014
(Seal)
My COMMISSION # FF233682
EXPIRES May 21, 2019
STATE OF FLORIDA�'
COUNTY OF "51)U
The Wfong instrum, gwas a nowledge beforeme
thisay of � ��/` � ZQ by
(Name of perm a4powl ng )
of Notar ubKfate of Florida I
Personally Known — OR Produced Identification
Type of Identification Produced
Commission No.
,401i a;4•b�
JOW.AINO" RAYMOND xiTZPATA4K
EXPIRES May 21, 2019
REVIEWS
FRONT
PLANS
VEGETATION
SEA TURTLE
MANGROVE
ZONING I SUPERVISOR
COUNTER
REVIEW i REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS