HomeMy WebLinkAboutnettles install 2SUPPLEMENtAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
ate:
Not Applicable
St. Lucie County rjnakes no representation that is granting a permit will authorize thepermit holder to build the subject structure
which is in confli t 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 pf 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 TOS OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvement$ to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the fir t inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner V Signature
STATE OF FLORIDA
COUNTY OF
The forgoing ind,trument was acknowledged before me
this day of 20 _by
1
(Name of perso acknowledging j
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
ctor/Lice'hse Holder
STATE OF FLORIDA
COUNTY OF L
The forgoing instrument was acknowledged before me
this 9 t3 day of _-, r 20 1 7 by
PCl-� `C , t` : G C._ C, r, t -r
(Name of person acknowledging )
(Signature of Notary Public- State of Florida }
Personally Known V OR Produced Identification
Type of Identification Produced
Commission No. (Seal) Commission - IICIA A. GiAWN
J4- e ; Moloy Public • State of Florida
Revised 07/15/2014=;? Commission N FF 133580
Bonded ThroWh National Notary Assn.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS