HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
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Building Permit Application AUG 2 0 2020
ST. Lucie County, Permitting
Commercial Residential x
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 325 Nettles bivd
Property Tax ID #: 4502-501-0511-000-6 Lot No. 325
Site Plan Name: Nettles island Block No.
Project Name:
DETAICED:DESCRIPTI`ON"OF WORK.
replacing a mobile home with a modular home
concrete foundation
CONSTRUCTIONINFORMATION: � -
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: $ 7000.00 Utilities: —Sewer —septic Building Height:
CONTRACTOR
Name sokolowski lawerence
Name: robert smith
Address: 686 w cuthbert blvd
Company: mithomes inc
Address: 2903 industrial ave two
City: haddon township State: ,
City: ft pierce State: fl
Zip Code: 08108 Fax:
Phone No.
Zip Code: 34946 Fax:
E-Mail:
Phone No 772 223 1179
Fill in fee simple Title Holder on next page (if different
E-Mail fivestarhousing2comcast.net
from the Owner listed above)
State or County License crc005706
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW" AIIVFORIVIATION
�k _ ,L'r R, l• t t
DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name: Jacobsen hmes
Name
Address: 600 Packardct
Address:
City: saWherWr
State:
City:
State:
Zip: 34W5 Phone 18DO282SM
Zip: Phone:
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.
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 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."
C&'w/GGli
S' ature of Owner/ Le ee/Contractor as Agent for Owner
Signa re o Co ra icense Holder
STATE OF FLORIDA
STATE OF FLO DA
COUNTY OF l�,�\,�
COUNTYOF
The forgoing instrument was acknowledged before me
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The forgoing instrument was acknowledged before me
this day of 2dZ�by
this day of � 20�SDby
Name of person making/statement.
Name of person making statement.
Personally Known ✓ OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
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