HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST RE COMPLETED FOR APPLICATION TO RE ACCEPTED
Date:
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Building Permit Application
Planning and Development Services
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: NEW MOBILE HOME SETUP
PROPOSED IMPROVEMENT LOCATION:
Address: a—J Ck C) GLADES CUT-OFF RD, PORT ST. LUCIE, FL 34987
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Property Tax ID #: 4220-434-0001-000-8 Lot No.
Site Plan Name: DEBORAH A. SHERROD Block No.
Project Name: SHERROD MOBILE HOME
DETAILED DESCRIPTION OF WORK:
NEW 30.0' x 50.0' PALM HARBOR MOBILE HOME SETUP
New Electrical Meter X Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
2 ,Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
❑✓ Electric ✓V Plumbing _ Sprinklers _ Generator — Roof Pitch
Total Sq. Ft of Construction: 1500
Cost of Construction: $ 138,616.00
Sq. Ft. of First Floor: 1500
Utilities: _Sewer ✓Septic Building Height: 15'
OWNER/LESSEE:
CONTRACTOR!.
Name DEBORAH SHERROD / SHOX LLC
Name: NATHAN HAYFORD
Address: 21750 GLADES CUT-OFF RD
Company: PALM HARBOR CONSTRUCTION
City: PT. ST. LUCIE State: _
Address: 605 S. FRONTAGE RD
Zip Code: 34987 Fax:
City: PLANT CITY State: FL
Phone No. 772.260.7821
Zip Code: 33563 Fax: 813.717.9842
E-Mail: PSLCOWGIRL@AOL.COM
Phone No 813.717.9841
Fill in fee simple Title Holder on next page ( if different
E-Mail ALLFLPERMITTING@AOL.COM
from the Owner listed above)
State or County License IH1122082
If value of construction is 2500 or more, a RECORDED Notice of Commencement Is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x 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 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 attornev before commencine- work or recordine vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/Livens der
STATE OF FLORIDA G\ - `
STATE OF FLORIDA
OF
COUNTY OF �T d�C�-L
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Swor o (or affirmed) and subscribed before me of
Sworn (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
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Physical Presence or Online Notarization
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Rev. 5/b/ZU