HomeMy WebLinkAboutBuilding Permit Application �r
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION-10. SE.A, CEPTED
Date: e I1 Permit Number: 5~ 19 o
ry
RECEi�'rD MAR 21 � :,
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 IMMOVEMENT LOCATION:
Address: 481 NETTLES BLVD
Legal Description: NETTLES ISLAND INC A CONDO SECTION II PARCEL
Property Tax ID#: 4502-501-0667-000-4 Lot No.481
Site Plan Name: Block No.
Project Name: L
Setbacks Front Back: - Right Side: I Left Side:
DETAILED DESCRIPTION OF:WORK:
2017 DOUBLEWIDE MOBILE HOME
20X39/40
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check all apply.
❑✓ HVAC Gas Tank ❑Gas Piping MGenerator
Shutters Q Windows/Doors
❑✓—Electric ❑✓_Plumbing Sprinklers 1:1 Roof
Total Sq. Ft of Construction: S .L. of First Floor:
Cost of Construction:$ 2475 U ilities: LJ Sewer 1:1 Septic Building Height: 13'
OWNER/LESSEE; t CONTRACTOR:
Name JOHN BURGESS Name: THOMAS GRUNDEL
Address:64 FURMAN AVE Company: Tom's Mobile Home Set-up
City: EAST PATCHOGUE State:NY Address: 4433 HENRY J AVE
Zip Code: 1 772 Fax: City: SAINT CLOUD State:FL
Phone No.631-463-8341 Zip Code: Fax:
E-Mail: hone No. 863 529 2370
Fill in fee simple Title Holder on next page(if different E-Mail: nancyarmstrong61 @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
commenciniz work or recording our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signa r`e df Contractor/I ontractor/I idense Holder
STATE OF FLORIM D r STATE OF FLORIDA
COUNTYOF COUNTYOFSTLuaE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisS day of �/c�o'� 20 /�by this 15 day ofC -7� 20 (7 by
THOMASGRUNDEL
(Name of person acknowledging) (Name of person acknowledging)
(Signature of ry Public-State of Florida) (Signature of o ry Public-State of Florida)
Personally Known OR Produced Identification Personally Known x OR Produced Identification
Type of Identificatio Type of Identification Produced FLOL
Commission No. , = 7.83
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ruary 10.2019
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE �I
INITIALS `