HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED }-
Date: 3/6/17 f�. Permit Number:
Building Permit Application MAR 15 2017
Planning and Development Services PERMlTT1jqG
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Mobile.home
PROPOSED;IIVtPROVEMENT.LOCATION "
Address: 7920 McClintock Way
Legal Description: Lot 1 in Block 75 of Fairways At Savanna Club Replat No. 1
Property Tax ID#: 3424-800-0163-000-7 Lot No.1
Site Plan Name: . Block No. 75,
Project Name: 1:1 2�3 I 01 �31 V6
Setbacks Front 15 �� Back: 1�Right Side: 7•5 Left Side- 7.5
DETAILE, D DESCRIPTION O WORK
Mobile Home Setup with plumbing, electrical and mechanical
CO STRUCTI INFORMATION
Additional work o e e orme under this permit—check a app y:n HVAC Gas Tank 0 El Shutters Piping _Shutters Q Windows/Doors
Electric F?i Plumbing OSprinklers gGenerator Roof
Total Sq.Ft of ConstructiQ� __Q _ S . Ft.of First Floor:
Cost of Construction:$ 5,000 Utilities:0 Sewer Septic Building Height:
0 NERAESSIEE `CONTRACT-OR: `
Name &,Ua47& es Avelteli
tta 6 Name: Thomas G.Jennings
Address: 36-0 PIAk AgAtc Alydate Company: Jennings'Mobile Home Setup;LLC
City: 6em&)' State: Address: P. O. Box 1428
Zip Code: 33S-7ef Fax: City: Auburndale State:FL
Phone No. Zip Code: 33823 Fax: 863-967-6655
E-Mail: Phone No. 863-965-0883
Fill in fee simple Title Holder on next page(if different E-Mail: jenningsmhs@tampabay.rr.com
from the Owner listed above) State or County License: IH1025176
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL°CONSTRUCTI�►'N LIEN LAW INFORMATION
N9 ✓` '
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 ancir 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.
—Signature of Owner/ essee/Agent Signature of Contra or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Polk COUNTY OF Polk
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 6 day of March 20 17 by this 6 day of March ,20 17 . by
Thomas G.Jennings Thomas G.Jennings
(Na a of per on acknowledging) (Nam of person acknowledging)
(Signature of Notary Publ State of Florida) (Signature of Notary blic—State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced e f identification Produced
.y „ KIMBERLYWA 7de
MY COMMISSION#FF 1 770 "A Commission No. FF184770 @; ) EXPIR[S:January7, OQDM 'ssion No. FFIS4770 I MYCatiM1SSION#r:_BondedThruNotaryPubfict1r ovdters _ ,:�; EXPIRES:Janua'a BondedThruNotaryPubB
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS