HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
0 ITo ��IGIIC �� RECEIVED
O
Building Permit Application JUN 2 8 2021
Lu®le Coun
Planning and Development Services St. PeltHna
Building and Code Regulation Division Commercial Residentiarml "
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: MOBILE HOME REPLACEMENT
S HEADER CANAL RD
Property rax iD #: �% l" 4vdlS— — Lot No. 01,1
Site Plan Name: Block No.
Project Name: PERCY
NEW MOBILE HOME
32X68
New Electrical Meter Second Electrical Meter
CON , "'aION'IfUFORMAT{ON: a h ,�w y y r y'`x.
7, >>5 3.. 85
Additional work to be performed under this permit- check all that apply:
Mechanical _ as Tank — Gas Piping — Shutters — Windows/Doors _ Pond
/Electric Plumbing — Sprinklers Generator _ Roof Pitch
6� —
Total Sq. Ft of Construction: 2084
Cost of Construction: $ Z (S
Sq. Ft. of First Floo . _
Utilities: —Sewer Septic
Building Height: 14'
,CONTRACTOR.
Name C- -�
Name:EDD1E GRUNDEL
Address.fp?� W Midway RD
Company:TOMS MOBILE HOMES
City: FT PIERCE State: _
Address:4460 BRADY
Zip Code: 34945 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
If value of construction is Z500 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.
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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 inconflict-with, any applicable Home Owners Association. rules; bylaws or and. covenants that -may restrict or prohibitsuch
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 w obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLOR A . I STATE OF FLORIDA
COUNTYOF-, COUNTY OF scwrae
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
_'hvsical Pre se a or Online Notarization xx 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 OR Produced Identification
Typ.Qf Identifica 'on Type of Identification
rodu d ProdiAced di
Sign urQofary Public- State of Florida) (Signature of Nota ublic- State of Florida )
Commissi CommiFizk"�,
oa FubNcte�.bolFb (e I)
ry �bh� Stele of FbridaY MIMS ARfNRTONG
• NANCY M)M5 ARMSTONG CommiubnW 013313
q, Expires 09/16 2023
REVIE UPERVISOR PLANS E I MANGROVE
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