HomeMy WebLinkAboutBuilding Permit Application =4
ALL APPLICABLE INFO MUST BE COMPLETED FOR-APPLICATION TO BE.ACCEPTED
Date: 3/6/17 Permit Number:`-10-6d o��S
R E C E 1 b'`�D i�AR w 2 20`97 I (�-eA L s
Building Permit Application
P/anning.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.IMPROVEMENTIOCATION
Address: 7800 McClintock Way
Legal Description: Lot 13 in Block 75 of Fairways At Savanna Club Replat No. 1
Property Tax ID#: 3424-800-0175-000-4 Lot No.13
Site Plan Name: Block No. 75
Project Name:
Setbacks Fropt& Back: 1 Right Side: 7�Left Side: 7�
DETAILED. DESCRIPTION`:OF
WORK: -
Mobile Home Setup with plumbing, electrical and mechancial
piPIA-e-LnPe
CONSTRUCTION,INFORMATION: ,
Acid itiona I work to be nartormed under this permit-chelln apply:
ZHVAC Gas Tank ❑Gas Piping _Shutters a Windows/Doors
ZElectric ✓❑_Plumbing Pprinklers Generator Roof
Total Sq.Ft of Construction: 1920 Sq.Ft.of First Floor:
Cost of Construction:$ 5,000 Utilities:11 Sewer Septic Building Height:
,OWNER/LESSEE: CONTRACTOR:
Name otra,44 10 Name: Thomas G.Jennings
Addresses: Company: Jennings'Mobile Home Setup, LLC
City: State:f(-- Address: P. O. Box 1428
Zip Code: ?1�1) Fax: City: Auburndale State:FL
�2 Phone Nol >%Tow o 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 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.
,�P'�tu,d,
_Signature of Owner/,Lessee/Agent Signature of Contra r/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.J4nnings Thomas G.Jennings
(Na a of pe son acknowledging) (Name of pe son acknowledging)
(Signature of Notary Pu ic-State of Florida) (Signature of otary P lc-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced of Identification Produced
KIMBERLYWATKINS
FF184770 MY COMMISSION N FF 1 0 '
Commission No. *' [L? l) EXPIRES:January 1�o fission No. FF�sa77o ;:' _ '; (S*)b1pMMISSIONYFF184770
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"� f ,.�''� Bonded Thru Notary Public Unde MUM
5a. 'de EXPIRES:January 7,2019
of„°"•'' Borded Thcu Notary Public Undewitem
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE COMPLETE �rr
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