HomeMy WebLinkAboutBuilding Permit Application . i�UfDlf7�
:SUPPLEMENTAL CONSTROUION 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:
Address: Address:
City: .City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
III*"
County makes no representation that is granting a permit will authorize the ermit holder to build the subject s�ructure
which is in conflict with any applicable Home Owners Association rules,bylaws or an covenants that may restrict or pro ibit such
structure.Please consult with your Home Owners Association and review your deed forany restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will, in all respects,peFform 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 afull 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 Cor
d and posted on the jobsite
before the first�insp tion. If you intend to obtain financing, consuJl ith lend r r an attorney before
commencin rko re 'in our Notice of Commencement. ..//
Sierfature of C&vnO AgpAttf Lessee Signa ure of ontraftor Li c nse Holderibeforeme
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STATE OF;FLORIDA j STATE O FL IDA (COUNTY OF COUNT OFThe forgoing instrument was acknowledged beforeIC)
The forgoing instrument was acknowledgedthisZfo dayof 20 1;r bythis Z to day of �01 " 7 20J_d`'i •�(ti ZcZvt-e.'�-f— rrA
(Name of person acknowledging) 0 (Name of perso cknowledging)
(Signature of Notary Public-State of Florida) (Si nature of Notary Public- orida
Personally Known -,4- OR Produced Identification Personally Known '/,— OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS