HomeMy WebLinkAboutBuilding Permit Application/-A
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/15/2021 Permit Number:
• _ _ -Q
Building Permit Application RECEIVED
Planning and Development Services
Building and Code Regulation Division MAR 01 2021
2300 Virginia Avenue, Fort Pierce FL 34982 t ,g Department
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residerfhm count
PERMIT TYPE: MOBILE HOME
P120POSfD IIVIiPROVEMENI'zLOCATIQN:A, wE., s-
Address: 204 NETTLES BLVD
Property Tax ID #: 4502-501-0390-000-1 Lot No. 204
Site Plan Name: Block No.
Project Name: BERNHARD
NEWAiOBILE HOME 2021
1
Additional work to be performed under this permit —check all that apply:
Mechanical Gas Tank _ Gas Piping Shutters
.Vf Electric Plumbing - Sprinklers Generator
Total Sq. Ft of Construction: 780
Cost of Construction: $ 15,000.00
Sq. Ft. of First Floor: _
Utilities: V(' Sewer —Septic
- Windows/Doors
_ Roof
Building Height: 13'
Pitch
01NNER/,..(ESSEE ` `,
CONTRACTOR x x
Name Ronald M Bernhard
Name: EDDIE GRUNDEL
Company: TOM'S MOBILE HOMES
Address: 204 Nettles BLVD
City: Jensen Beach State: _
Address: 4460 BRADY RD
City: ST CLOUD State: FL
Zip Code: 34957 Fax:
Phone No.
Zip Code: 33472 Fax:
E-Mail:
Phone No 407-709-1490
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 IH1118467
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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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: `
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF /S�
COUNTY OF srLucie
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 20_ by
this 15 day of FEB 20_ by
t O& aw hAd
EDDIE GRUNDEL
Name of person making statement.
Name of person making statement.
Personally Known D L OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Prod ced
Produced DL
(Signatur i a
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Rev. 217119