HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:'3 a.1 Permit Number:
RECEI'.' I PEAR 21 7.017
Building Permit Application
Planning and Development Services Building and Code Regulation Division l-/y 0) c �'"�
2300 Virginia Avenue,Fort Pierce FL 34982 ff-� v? J
Phone: (772)462-1553 Fax: (772)462-1578 CommercialResi ential X
PERMIT APPLICATION FOR: Mobile home
PROPOSED IMPROVEMENT.LOCATION:
Address: 99 NETTLES BLVD
Legal Description: NETTLES ISLAND INC A CONDO SECTION II PARCEL
Property Tax ID#: 4502-501-0285-000-2 Lot No.99
Site Plan Name: Block No.
Project Name:
Setbacks Front 346 Back: Right Side:_�Left Side:b
DETAILED DESCRIPTION OF WORK:.'
2017 DOVBEEWR39 MOBILE HOME l�jd X 4� VACUk \ry �
CONSTRUCTION INFORMATION:
Additional work to e e orme under t -checkispermit a apply:
ZHVAC Ei Gas Tank []Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers E Generator Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ 2475 Utilities:Sewer F-1 Septic Building Height: 13'
OWNER/LESSEE: CONTRACTOR:
Name GAYTON KYES Name: THOMAS GRUNDEL
Address: 1820 NE JENSEN BEACH BLVD Company: Tom's Mobile Home Set-up
City: JENSEN BEACH State:FL Address: 4433 HENRY J AVE
Zip Coded'U957 Fax: City: SAINT CLOUD State:FL
Phone No.561-767-6310 Zip Code: 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: IH1025148
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 your Notice of Commencement.
_4A Nn 41J 1 1 1 4� WrA4 D?44,
Jl� s
_Signature •f Owner/Lessee/Agent Signature of C ntractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF ( Gc.0 COUNTY OF STLUCIE
The forgoing instrum�er t was acknowledged before me The forgoing instrument was acknowledged before me
this day of 201 aby this 15 day of '0(=a- 20 n by
------------
THOMAS GRUNDEL
(Name of person acknowledging) (Name of person acknowledging)
(Signat re o N tary Public-State of Florida) U (Signature of N 014,ar ublic-State of Florida)
Personally Know ..;. 0 r iFtea' Personally Know ��" O1f3�R�®�y�yI ONG
N� MIMS ARMSTRO
Type of Identific o4�ced IVG Type of Identific �io, .rol�u�gd
MY - MISSION#FF197899 .9ta` EXPIRES Feb 197899
a. EXPIRES Fe Commission No �'o�ias ru 2019
Commission No. at5eaf)�0,2019 3 ridallotarySeivi
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Revised 07/15/2014
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