HomeMy WebLinkAboutBuilding Permit Application (2)SUPPLEMENTAL. LIEN La1N
Name: — .-.---------
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: —
Address:
City:
Zip: Phone:
ORMATION:
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City: State:
ZiP: Phone:
BONDING COMPANY:
Name:
Address:
City:
4IP= Phone:
Not Applicable
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 Nome 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 wilt, in all respects, perform the work
in accordance with the approved pians, 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 your Nntira of
_, z119pture-ot Owner/ Lessee/Agent
STATE OF FLORIDA� J
COUNTY OF
The Ing instrume was
acknowledge fore me
thisfday of 20 % by
'Na_Anl-)� llu&at�
me of person acknowledging )
VW 8rlj" 11 )0 ih -
(Signature of Notary Public- State of Florida )
Personally Known —L OR Produced identification
Type of identification Produced
MY COMMISSION # FF9W63
STATE Of FLORP3 J J
COUNTY OF_ � �/ 6- 1,,5;'
The fo oing instru nt was acknowledged before me
this day of alt _ 20 -Liby
(Name of person aLkn2ledging)�
— () & 0 61-o k, o �/ 1/2 hm 6L,
(Signature of Notary Public State of Florida )
Personally Known _X_ OR Produced Identification
Type of Identification Produced
REVIEWS FRONT ZONING SUPERVISOR PLANS
COUNTER REVIEW REVIEW REVIEW
DATE
INITIALS
2 iC' In6.3 (Seal)
ANNie SIR
WY COMMISS ,# FFg8�
EXPIRES ION 4S83
Apri121, 2020
VEGETATION I SEA TURTLE IMANGROVE
REVIEW REVIEW REVIEW