HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST
Date_
ZMPLETED FOR APPLICATION TO BE ACCEr ED ^�
Permit Number: lX O
Building Permit Application
Planning and DeveiopmeMServices IT4A �247
Building and Code Regulation Dhdsdon 401'p
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23CO qWo Avenue, Fort Pierce Ft 34982 00a� Vi 0�r
Phone:(772)462-1553 Fax:(7n)462-L57a Commercial Residential x
PERIVIrrTYPE. Park Model
PRO POSED=.IttiMP.ROVEMENT LOCAtION: v
Address- 1157 NETTLES BLVD
Property Tax ID 4: 4502-501-1344-000-1
Site Plan Name:
Profet3 Name: Rabotham
Lot No.
Block No_
QETAILEIXDE5CRIPTi 0 OFsWORKc
Tiedawn a park model
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_Electric _Piumbing _Sprinklers _Generator
Total Sq. Ft of Construction: Sq_ Ft of First Floor _
Cost of Construction: 5 Utilities: —Sewer _Septic
_ Windours/DDors
Roof Pitch
Building Height:
Q,L'dNERfLE55EE
CONTRACTOR:' �3�>tiwn� f.<=
Name: tt Rtn n
Address:29 Megan RD Hyannis, MA 02601-2508
Company: Anchor Dcm
City: Hyannis State: _
Tip Code: 02601 Fax:
Phone No_
Address: 7205 Santa Clara Blvd
City: Ft Pierce State:_
Zip Code: 349SI Fax:
Phone No 77237W890
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail anchafdmvnmobilehomes@gmail-cam
State or County License IH1101137
If value of construe lon is $250® or more, a RECORDED Notice of Commencement Is required.
If value of 11VAC is $7,500 or more, a RECORDED Notice of Commencement is "ulred.
UP
_ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
ORMATION ..,�' r �
MORTGAGE COMPANY: _ Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application Is hereby made to obtain a permit to do the work and Installation as Indicated.
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 full concurrencyreview: room additions,
accessory structures, swimming pools, fences, wells, signs, screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAMURE 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
WITM YOUR LENDER OR AN ATTORNEY BEFORE RECORDING TIOUR NOTICE OF COMMENCEMENT."
\ C
f �� A/
Sig ature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor(Ucense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF v.
COUNTY OF 2—
The forgoing Instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 2D day of .20_ by
this rD day of nveerrau 20_ by
Name of person making statement.
Name of person making statement_
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of identification
Type of I dentification
Pr uced a
Produced -
6 - -Z��d
(Signaturd of No rp Public- State of Florida)
(Signature of Not P a i I
gW"%4', NotaryPublrlp, S�ttaptet of iori
Commission No. e0 NotaryP�[9Q61taofFlorida
Commission No. Mr COMMal�B��G3s19r3g13
• .a
Nanry Mims Armstrong
Mr Commission GG 813313
F�rpires 09l1&2023
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