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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:��
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` ._,f:_=.. _ � _ - � Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential XX
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: MOBILE HOME REPLACEMENT
Address: 2062 NETTLES BLVD
Property Tax ID #: 4502-501-0065-000-4 Lot No.
Site Plan Name: Block No.
Project Name: HASTIE
NEW MOBILE HOME REPLACEMENT
20X43/49
New Electrical Meter
Second Electrical Meter.
Additional work to be performed under this permit —check all that apply:
`Mechanical _, Gas Tank r Gas Piping _ Shutters _ Windows/Doors Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ z 6� Utilities: _ Sewer _ Septic Building Height: 14'
�Vt �L�ii t
NameLarry N Hastie
Name:EDDIE GRUNDEL
Address:2062 NETTLES BLVD
Company -TOMS MOBILE HOMES
City: JENSEN BCH State: ,
Address:4460 BRADY
Zip Code: 34957 Fax:
City: ST CLOUD
State: FL
Phone No.
Zip Code: 34771 Fax:
E-Mail:
Phone N0407-709-1490
Fill in fee simple Title Holder on next page (if different
E-Mailnancyarmstrong6l@gmaii.com
from the owner listed above)
State or County License ih1118467
IT value oT construction is zbuu or more, a Keuom ev motice at commencement is required.
If value of HAVC is $7,900 or more, a RECORDED (Notice of Commencement is required,
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OESIGRIER/ENGINEER: _Not
Applicable
iIAORTGAGE 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:
Blame:
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. if you intend to obtain finanrina_ _ rnncl Ilt
or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF euucie
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization Xa Physical Presence or Online Notarization
this day of 2020 by this 10 day of June 2020 by
EDDIE GRUNDEL
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known x
Type of Identification Type of Identification
Produced I excidbuced d+
(Signature of Notary Public- State of Florida ) (S gnat r,e o
Commission No. (Seal) Commission No.
REVIEWS I FRONT ONING COUN ER I REVIEW I SUPERREVIEW
PubHc
OR Produced Identification
(Seal)
MANGROVE
REVIEW