HomeMy WebLinkAboutBuilding Permit IX{,
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772).462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mobile home
PROPOSED IMPROVEMENT LOCATION
Address: 478 NETTLES BLVD
Legal Description: NETTLES ISLAND INC
Property Tax ID#: 4502-501-0664-000-3 Lot No.478
Site Plan Name: Block No.
Project Name:
Setbacks FrontBack:!S.5 Right Side: Left Side:
DETAILED DESCRIPTION OFWORK:
2017 DOUBLEWIDE MOBILE HOME
22X40/29
CONSTRUCTION INFORMATION
Additionalwork to be nertormed under this permit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers 0 Generator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ :~Utilities: `� Sewer Septic Building Height: 13
2475
OWNER/LESSEE ;.CONTRACTOR:-..
Name JAMES JENSEN Name: EDDIE GRUNDEL
Address:478 NETTLES BLVDCompany: Tom's Mobile Home Set-up
City: JENSEN BCH State:FL Address: 4460 BRADY
Zip Code: 34957 Fax: City; SAINT CLOUD State:FL
Phone No.914-329-3250 Zip Code: 34772 Fax:
E-Mail: Phone No. 863 529 2370
Fill in fee simple Title Holder on next page(if different E-Mail: nancyarmstrong6l@gmail.com
from the Owner listed above) State or County License: IH1118467
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION 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.
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 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 recording our Notice of Commencement. s
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_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
Theforgoing instr ent as acknowledged before me The forgoing instrument was acknowledged before me
this J`� day of 201 7 by this 5 day of JULY 20 a_by
EDDIE GRUNDEL EDDIE GRUNDEL
(Name of person acknowledging) (Name of person acknowledging)
(Signature oft)tary Public-State of Florida) (Signature of N to Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced FLDL Type of Identification Produced FLDL
Commission No. (Seal) Commission No. (Seal)
;r°• _~
Re tAJJOMMISSION#FF197899 MY COMMISSION#FF 97u'?9
EXPIRES February 10,2019 EXPIRES February!10.2019
on ace.cum to eiv e.con.
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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