HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR-APPLICATION TO BE ACCEPTED
Date: 5\l `1\1 Permit Number: -
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RECEIVED 0 9 2011
Building Permit Application
Planning and Development Services
Building and Code Regulation Division I
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: 100 VINDALE AVE
Legal Description: BEL-AIRE ESTATES BLK 2 LOT 16
Property Tax ID#: 1312-701-0031-000-9 Lot No. 16
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
FpiTAILEDIDESCRIPTION.OF WORK
USED MOBILE HOME REPLACEMENT
CONSTRUCTION,INFORMATION:
Additional work to b fl
orme un er t is permit—c ec a app y:
❑✓ HVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors
ZElectric ❑✓1 Plumbing Sprinklers Ei Generator F] Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ �Y /�� Utilities: _Sewer Septic Building Height:
`OWNER/LESSEE: , CONTRACTOR:
Name ROBERT HOCHENDONER Name: RONALD BLAIN
Address:188 IMPERIAL WAY Company: ANCHOR DOWN MOBIE HOMES
City: FORT PIERCE State:FL Address: 7205 SANTA CLARA BLVD
Zip Code: 34951 Fax: City: FT PIERCE State.FL
Phone No. Zip Code: 34951 Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
/ro
If value of construction is$2500 or.more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE'COMPANY: Not Applicable
-City: Stat tat
ip: one: p Phone;
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING C01411PANY _Not Applicable
.Name• Name:_
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
(.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 ppermit.holder to build the subjectstructure
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 herebyagree that l:wilIli 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 undergoin&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:Yourfailure to Record a:Notice of Commencement.may result irryouur 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 attorneybefore
commencing work.or recordingour Notice of Commencement.
5
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FL O 1 STATE-OF FLORIDA
COUNTY OF F' - —' COUNTY OF sTJJd1E
The forgoing.instr eft was acknowled erj befote:me The forgoing instrument was acknowledged before me
this day of 2b ` by this2 day of 'y ZO 12 by
i
a•t � 1 1 RONAW BI AIN
(Name of person acknowledging) (Name of person acknowledging)"
i
(Sign ture of N to Public-State of'Florida) (Sign ure o tary Pub'c-State of Florida)
Personally Known OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produce Type of Identification Produced
oWpa WANCMNIIM$ARIUI ,�.a.Pye NANCY I S�IARMSTR0f4G
Commission N iyigg{¢Seitlf E.?97893 Commission.No: _ ` MY co
ISSfON#FF19M99
EXPIRES Ee gry.10;2019
q _ „orr EXPIRES February 10,"Pol9,
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Revised 07/15/2014 ` �d
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