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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED //__ G
Date: �. Permit Number: /&, iJ / n--7 •
- RECEIVED
Building Permi pplication JUL 14 2016
Planning and Development Services rn O (DJ O-7_ o4JW
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: 10701 S OCEAN DR 892
Legal Description: VENTURE OUT AT INDIAN RIVER INC
Property Tax ID #: 4511-510-0093-000-5 Lot No. 892
Site Plan Name: Block No.
Project Name:
,
Setbacks Front -
_ Back: Right Side: Left Side: /
DETAILED DESCRIPTION OF WORK:
SINGLE WIDE MOBILE HOME L+
CONSTRUCTION INFORMATION:
Additional work to e e orme under this permit —check a apply:
�HVAC El Gas Tank Gas Piping 1:1_ Shutters Windows/Doors
Electric ❑✓ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 532
Cost of Construction: $ 2475
S Ft. of First Floor: _
Utilities:R Sewer F]Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name DAVID L BUTTS
Name: THOMAS GRUNDEL
Address: 10701 S OCEAN DR 892
Company: Tom's Mobile Home Set-up
City: JENSEN State: _
Zip Code: 34957 Fax:
Phone No. 772-607-3214
Address: 4433 HENRY J AVE
City: SAINT CLOUD State: FL
Zip Code: Fax:
Phone No. 863 529 2370
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: nancyarmstrong61 @gmail.com
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:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
BONDING COMPANY:
Name:
Address:
Citv:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
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 prop rty. A Notice of Commencement must b corded and posted on the jobsite
before first inspection/#you intend to obtain financing, consul it lender o n attorney before
comm clnl? work or recd ding vour Notice of Commencement.
s
_ Signature of Owner/ Lessee/Agent
STATE OF FLOIA
COUNTY OF
The for oing in ent was acknowledged before me
this 7 day o 201 -by
(Name of person acknowledging)
of Contractor
STATE OF FLOFUDAv
COUNTY OFu
The forgoing ins ru ent was acknowledged before me
this day of 20 L_�2 by
(Name of person
'i�ignatilire of N tly
Public- State of Florida ) (Signdture of 10ry Public- State of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of en 4 y, d
MIMS MS ARMSTR
Commission (Seal) Commi = MY N # FF1 7899
o. EXPIRES Februa 97899
jAtvCY MIMS ARpgSTRONG (a�7139r ;3 ry 10. 201
S{ON # FF197899 ry�
Revised �� /2014 S February 10, 201g
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
u I
INITIALS
i
•
PERMIT ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
•
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number. A Cl Ly 3 .-
State of Florida Certification Number (Irippl;cahie7 G C- I Y U U & 3 -7 C,) _
John Law Electric
(Company Namc/lndividual Name)
Elst;trical
(Type of Trade)
have agreed to he the
Sub -contractor for Tom's Mobile Home Set-up
(Primary Contractor)
For the project located at 10701 S OCEAN DR 892
(Project Street Address or Property Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, 1 will immediately advise the Building and Zoning Department of St. Lucie County by filing a
Change of Sub -contractor notice. (Form: SLCCDV (No. 004-00)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE. REQUIRED
Business Name: Law'S Electri _el AcP_1nc-
Address: 5158 NW Primm St
_ t 1ZrCie FI.34983
City/State/Zip:
Phone: ____ 7%e % email: SSE r101. ('o
S C/ ti Al G-7 IS- /
SIGN URE PRRIN/T NfA,NI'E DATE
STATE OF FLORIDA, COUNTY OF } . !ti,(1C j e,
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY OF
RY ,��� j�,) WHO IS PERSONALLY KNOWN ^OR HAS
PRODUCED
- (1, a— t!
SIGNATURE OF NOTARY PUBLIC
SLCPDS: 08/06/2014
AS IDENTIFICATION.
0,1n�9&Avo twnv
PR NAME OF NOTARY PUBLIC
(STAMP)
AN NE BROWN WAIMACH
MY COMMISSION # FF984663
•'.,"! `� EXPIRES A! 21, 2020
Noy �aotsa
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PERMIT $9 ISSIiE D4TE ��.
, PLANNING & DEVELOPMENT SERVICES
Building & Cade Compliance Division
07 JUL 2 6 2016
BUILDING PERMIT
SUII-CONTRACTOR AGREEMENT e'ERFM TfING
��
St. Lucre County Contractor Certification Number: � ly 7 �2--
oi. Lucie County, FL
State of Florida Cereification dumber (irspoimbte7 a—c- ) 7 0 G (1 3 -7r� _
John Law Electric have agreed to be the
(Company NameAndividual Name)
Ek�cWcal Sub-,ontractorfor Tom's Mobile Home Set -pup_
rrype of Trade)
Forthe project located at 107015 OCEAN DR 892
(PrimaAy C�rra�tor)
(Project Street Address or Property Tax TD if)
It is understood that, if there is any change of status regarding our participation with the above menti3ned
project, I will immediately advise the Building and Zoning Department oFSL Lucie County by filing a
Change of Sub -contractor notice, (Form: SLCCDV (No. 00"0)
BUSINESS QUALMER (Name of the Individual shown on the Contnaor's Uccnse)
NOTARIZED SIGNATURES ARE REQUIRED
Business Name: L.aWs Electrical �ptyir lrls
Address: 5158 NW Primm St
Pt St Lucie Fl.M83—
City/slate zip:
Phone:
-77d G'/ T-r7
42, / I -T—at" /-z - -
SIGNAIM PRINT NAME DATI~
STATE OF FLORIDA, COUNTY OF
THE FORE.COING INSTRUMENT WAS SIGNED BEFORE ME THIS / J DAY OF / z0
WHO IS PERSONALLY KNOWN ORHAS
PRODUCED
'04LL &WA W L
SIGNATURE OF NOTARY PUBLIC
SLCPDS: OIi1O0014
AS IDENTIFICATION,
�2nfz9&01)0 r (S7, r.Mp)
PR NT NAME OF NOTARY PUBLIC
ANNE BROWN WAWCN
's - MY COWAMION 0 Fe'8$4W3
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PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel IM/Legal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
I further acknowledge that in granting this permit for the development of this property,
St. Lucie County is neither obliged nor liable to provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
r erty et�atne tease nt)
operty Owner Signature
Date
STATE OF FLORIDA, COUNTY OFZ•--
ACKNOWLEDGED EFORE ME THIS t6 __.. DAY OF )_ , 20A_�,
BY ,� WHO 15 PERSON Y KNOWN TO ME I OR WHO HAS
MON.
COMMISSION NUMBER
` t �1SMN °:Fr12978"EXPIRES February019St�ric
t
•
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
0GO-o-, i
(Parcel .ld#/Legal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, .BP Number , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
I finther acknowledge that in granting this permit for the development of this property,
St. Lucie County is neither obliged nor liable to provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
IN 7 nrer ame Please mt)
roperty Owner Signature Date
STATE OF FLORIDA, COUNTY OF Ll�'
ACKNOWLEDGED,BEFORE ME THIS l DAY OF 20,
By �Du N X1 1 - S WHO IS PERSON Y KNOWN TOME L--J OR WHO HAS
SLCPDSD Revised 04/11/2011
AS IDENTIFICATION,
ARY PUBLIC TYPE OR PRINT NOTARY
COMMISSION NUMBER _.._.
AAMSTRONG
i tv1: 864MISSION 4 FF197899
EXPIRES February 10, 2019
•, 1 F�"WNOIdI'
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (If applicable): .
Tom's Mobile Home Set-u
(Company Name/Individual Name)
Plumbina
(Type of Trade)
IH1025148
have agreed to be the
Sub -contractor for To m's Mobile Home Set- u
(Primary Contractor)
For the project located at 10701 S OCEAN DR 892
(Project Street Address or Property Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, I will immediately advise the Building and Zoning Department of St. Lucie County by filing a
Change of Sub -contractor notice. (Form: SLCCDV (No. 004-00)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURES ARE REQVIRFD
Business Name:
Address:
City/State/Zip:
STATE OF FLORIDA, COUNTY OF
THE FOREGOING
WAS SIGNED BEFORE ME THIS `6 DAY OF
20L-P
OR HAS
P UCEDAS IDENTIFICATION.
NANCY MIMS ARMSTRONG (STAMP)
MY COMMISSioN # FF197899
SIGNATI
SLCPDS:
PUBLIC
398 53
PERMIT # ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (a' applicable):
Central Air Systems
(Company Name/Individual Name)
HVAC
(Type of Trade)
For the project located at
CAC054741
have agreed to be the
Sub -contractor for To m's Mobile Home Set- u p
(Primary Contractor)
10701 S OCEAN DR 892
(Project Street Address or Property Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, I will immediately advise the Building and Zoning Department of St. Lucie County by filing a
Change of Sub -contractor notice. (Form: SLCCDV (No. 004-00)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNATURyf ARE REQUIRED
Business Name: ,
i
Address: '' nn (Q, - r
City/State/Zip: W �� -t ►'Y-,% G��
Phone: J � tP0 �� � l� I email:
��cv� ���T �.t//D ✓ V mac. / 1 f /1 �p / d l �v
SIGNATURE PIUNT NA DAT
STATE OF FLORIDA, COUNTY OF
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS/0 DAY OF 920/-(,':,'
BY L)R�ib WHO IS PERSONALLY KNOWN OR HAS
-XROKCED C&D L J AS IDENTIFICATION.
(STAMP)
SIGNATURE 06bTARY PUBLIC PRINTNAME OF NO ;v NA
NCY MIMS ARMSTRONG
SLCPDS: 08/06/2014 MY COMMISSION # FF197899
(ao7)39S February 1o. 2019
? EXPIRE
3 FAor �y
PERMIT # ISSUE DATE
„y PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
St. Lucie County Contractor Certification Number:
State of Florida Certification Number (If applicable):
JAMES P FITZGERALD
CGC059461
have agreed to be the
(Company Name/Individual Name)
STEPS AND SKIRTING Sub -contractor for Tom's Mobile Home Set-up
(Type of Trade)
For the project located at 10701 S OCEAN DR 892
(Primary Contractor)
(Project Street Address or Property Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, I will immediately advise the Building and Zoning Department of St. Lucie County by filing a
Change of Sub -contractor notice. (Form: SLCCDV (No. 004-00)
BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License)
NOTARIZED SIGNAATUURESS ,ACRE REQUIRED
ED
.I Business Name: /&)-_"
Address: 6560 NW 13TH CT
City/State/zip: PLANTATION, FL 33313
Phone: email:
JAMES P FITZGERALD
SIG URE PRINT NAME DATE
STA E OF FLORIDA, COUNTY OF FLORIDA
THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 8 DAY OF J U LY , 2016
BY JAMES P FITZGERALD WHO IS PERSONALLY KNOWN X OR HAS
F L D L n AS IDENTIFICATION.
NANCY M ARMSTRONG (STAMP)
NOTARY PUBLIC PRINT NAME OF NOTARY PUBLIC
114
"VA ".L% NANCY MIMS F
AR STRONG
MY COMMISSION # FF1978%
EXPIRES February 10, 2019
(407) 39e 53 F1WKWlotery3etvKR.Gom