HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/6/17 Permit Number: Viln-04`%
J,-z d_ RECEIV'�:D MAR ?ti 2017
•
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 IMPROVEMENT-LOCATION:
Address: 7904 McClintock Way
Legal Description: Lot 5 in Block 75 of Fairways At Savanna Club Replat No. 1
Property Tax ID#: 3424-800-0167-000-5 Lot No.5
Site Plan Name: Block No. 75
Project Name: ` I
Setbacks Front Back: Right Side:. Left Side:
DETAILED DESCRIPTION'OF WORK:
Mobile Home Setup with plumbing, eletrical and mechanical
CONSTRUCTION INFORMATION:
-
Additional work to be ertormed under t ispermit—check all apply:
�HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
ZElectric 0 Plumbing Sprinklers F]Generator Roof
Total Sq. Ft of Construction: 1760 S Ft.of First Floor:
Cost of Construction:$ 5,000 Utilities:nSewer F�Septic Building Height:
OWNER/LESSEE: 11 CONTRACTOR:
Name l2.$ Name: Thomas G.Jennings
Address: Company: Jennings'Mobile Home Setup, LLC
City: G,eAtrrL�;� State:EEL Address: P• O. Box 1428
Zip Code: "1 Fax: City: Auburndale State:FL
Phone No. o c�(p 3-9(0E DSR )j 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.retl Y
SUPPLEMENTAL CONSTRUCTIONLIEN 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.
S
_Signature of Owne Lessee/Agent Signature of Contra r/Licerise 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 1 by this 6 day of March 20 17 by
Thomas G.Jennings Thomas G.Jennings
(Nam of person acknowledging) (Nam of pe on acknowledging)
(Signature of Notary Pub i -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 Type of Identification Produced
Commission No. FF18477r) � Y' ea fOMBERLYWDUnde'Writels
mission No. FF184770
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MY co,%wisSION eve•,
EXPIRES:Janu h4Y COh1MiSSim#FF 184770
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Revised07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW R VIEW REVIEW REVIEW REVIEW REVIEW
DATE ` I
COMPLETE Li i l
INITIALS