HomeMy WebLinkAboutBuilding Permit Application (2)SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/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:
BONDING COMPANY: Not Applicable
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_af-rf_cording your Notice of Commencement.
Signature of Owner Lessee/Contractor as Agent for Owner
STATE OF FLOR
COUNTY OF if
The for oing instrument `was acknowledged before me
this day of �x1.,tiw�]; 20 Jby
(Name of person acknowledging,},
(signature of Notary PU,0Rc- State of FloMa }
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15
JOHNA1HAN RAYMOND FITZRAT,,CX
EXPIRES May 21. 2019
Signature of ContragCor/License Holder
STATE OF FLORI
COUNTY OF �_ft u
The forgoing instrument was acknowledged before me
this day of-rnLtlL�a , 20 by
(Name of person acknowledging)
ature of Notary PflbV State of Florida )
Personally Known r OR Produced Identification
Type of Identification Produced
Commission No.
,."01hJOHN AlHANRAYMANA s
ITtPA1RUCK
`?a EXPIRES May 21, 2019
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