HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 62 O(Q-07
91T. WOE
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential XX
I PERMIT APPLICATION FOR: MOBILE HOME I
Address:
Property Tax ll)#> 2QQ&_ 143 1_V601_Qz_6 Lot No.
Site Plan Name: Block No.
Project Name:
New Electrical Meter Second Electrical Meter
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Additional work to be performed under this permit —check all that apply:
V Mechanical Gas Tank —Gas Piping Shutters L2�� Windows/Doors Pond
V"Electric /Plumbing Sprinklers Generator cRoof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor -
Cost of Construction: $ 150960 Utilities: —Sewer V/Septic Building Height:
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Name lel-- I
hc
ame:EDDIE, GRUNDEL
Addr s: �V
compa ' hy:TOMS, MOBILE HOMES
City c4a.,hogaa- LJ StatP00
Address: 44.60- BRADY . R D
Zip Cocler/ Yt/&7-9 Fax:
City: ST CLOUD State: FL
Phone No.
Zip Code:.34711 - Fax:
E-Mail:
Phone No
Fill in fee simple Title Holder on next page if different
E-Mail nancyarmstrongl ;l,@gmaii.com
from the Owner listed above)
'011184697
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.-
I
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required..
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Appli•cable�:'
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:
City:
Address:
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 financing, consult
with lender or an attorneybefore commencingwork or recordingour Notice of Commencement.
Rev. DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORID
STATE OF FLORI •A'"r
COUNTY OF �
COUNTY OF c��
S orn to (or affirmed) and subscribed before me of
Physical Pr Online Notarization
Sworn to (or affirmed) and;s`u'bscribed before me of
� Physical Presence or Online Notarisation
ce or
this �' day of 2020 by
this em day of Tune �•2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known � OR Produced Ideniific�xion.
Type of Identification
Type of Identification
Produced
P cedoL
Sign ur yPublic-State of Florida(Signature
of Na Public- State of FloridaCommissiN�rPuw;csleceaFal)Comeal)
rNo
S ARMSTONG
Notary Public S1�te of Florida
� �nmission GO 913313
f� NANCY MIMS ARMSTONG
�resoerlaza
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REVIEWS
FRONT
UPERVISOR
PLA 5�
MANGROVE
COUNTER
REVIEW
REVIEW
REVI
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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