HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1
Date: Permit Number: 1 ® (
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__-------. ......_ _...__._ __ Building Permit Application
Planning and Development Services
(Building and Code Regulation Division
12300 Virginia Avenue, Fort Pierce FL 34982
(Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
IPERMIT TYPE: DEMO OF OLD MOBILE MOBILE HOME
PROPOS'.ED IIVIFROUEMENT LOCATION;INSTALL NEW MbBILEnHOME 26'8"X 613 , s,: x
Address: 1936 BLUEFIELD RD
Property Tax ID#: 4104-243-0040-000-0 Lot No.
Slite Plan Name: Block No.
Project Name: RODRIGU,EZ PERMIT
�DETAILED7DESCRIPTION OF�WORK `�� � � x �' � � � ' i
(REMOVE OLD MOBILE HOME TO INSTALL NEW MOBILE HOME
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CQNSTR JCT10N INFORII/I"ON
Additional work to be performed under this permit—check all that apply:
,[Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 2475.00 Utilities: Sewer _Septic Building Height:
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OWNER%LESSEE s t, 7 T= °, a £} k ;CONTRACTOR
Name D & B Inc Name:GENE ROBERT BRITT
9300 S Dadeland Blvd FL 5 CHASE LAND SERVICE LLC
Address: Company:
City; MIAMI State:_ Address:26532 E ST RD 78
Zip Code: .33156 Fax: City: OKEECHOBEE State:FL
I Phone No. Zip Code: 34974 Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page(if different E-Mail NANCYARMSTRONG61(PGMAIL.COM
from the Owner listed above) State or County License CGC1527179
j If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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J .�ONSRIT� � Ilt: != A11�f1 IC} IAT#fl
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IDESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
lAddress: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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
iin 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 JOB SITE,BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN-ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLO D STATE OF FLORIDA
COUNTY OF �,Gl��2� COUNTY OF
The fo ing ins u sacknowledg��pefore me The f gping instru e t w a owledg efore me
this of 20 `�7 by this90 of 0 by
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✓ '� GENE BRITT (_yn A& (2,--� bj�
Name of person making statement. Name of person making statement.
Personally KnownT.4PW
i ' Personally Known ^x OR Produced Identification
Type of Iden ' at Np�ry public State of Fbrida Type of Identificati
Produced i Nan Mims Armstrong Produced cL r Notary Public State of Florida
c ommission GG 913313 ancy Mims trong
x 'res 09M/2023 a y Commissio 13313
p'e 9 /
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natur of Not Public-State of Florida( g ) (Signature of (ary Public-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
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