HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED'FOR"APPLICATION TO BE ACCEPTED _
Date:.0.5122/2021.
Permit Numbe"r:. clI
A � F�
ORT c tti lw
Building Permit Application
Planning and.Dev..elopment Services
Building and Code Regulation Division Commercial; R@stdentl8l x
_ .
2300 Virginia:Avenue,.Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578.
PERMIT APPLICATION FOR;
Mobile Home
'PROPOSED,IMPROVEfViE,NT LOCATION r
Address6g2-Pulitze. r Road Fort Pierce,"Florida 34945
2308-700-00W-00.0-4
Property Tax i D 4: Lot No:2,
Site Plan Name: Block No: ._....
Project Nome:
Denise Guettler
DETAILED DES
CRdPTIQIW OF WORK:
Install Mobile Home, Plumbing, Elecfrical, and`Mechanical
New Electrical Meter Second Electrical Meter
f
CONSTRUCTtON.INFORMAT(ON -
Additional wiork to be perforrried: underthis permit—check all that apply
Mechanical _Gas Tank _.GasPi,ping _Shutters —Windows/Doors _Pond
Electric: Plu.robing _`Sprinklers _Generator _'Roof Pitch
Total Sq. Ft of Construction: 1680 Sq. Ft. of first;Floor:
20,675.00
i3 g
Gost of Constiruction:$ Utilities: _Sewer Se-
p tiC Buildin 'Hei ht _
yOWNER/LESSEE CONTRACTOR
.,.
Name DeniseGuettler Name:JackiecPeterson
Address:540 Pulitzer Road Company Big Daddy`s Mobile Home Set Up
City. Fort Pierce State: I' Address:621 Avenue A Wahneta E
Zip Code ,34,945 Fax: City Winter Haven Stafe'FL.
Phone:No. Zip Code: 3388.0 Fax: M3421 6430
E.-.Mail. Phone N063-421-6400,E
Fil in fee simple Title.Holder=on next.page(if different E=Mail kerrifutrell@msn.com
from the Owner listed above) State or County License 1H1025291
Ifvalue of construction is 2500 or more,a,RECORDED Notice of Commencement is required.
If:value pf HA,VC"-is$7,500 or More,;a RECORDED°Notice.of.;Commencement is required.
SUPPLEMENTALCONSTRUCTION L{EN LAW IN�FORMAT{ON
5:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY:r —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:.
II
Zip:. Phone: Zip: Phone:
OWNER/CONTRACTOR.AFFIDVIT:Application is herebymadeto 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.Countyy makes no representation that is,granting a per.mitwillAuthorize:the-ppermit holder to build,the su.bjectstructure
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. our HOME Owners Association and:review ourdeed foran restrictions which
Y.. Y . .. y may apply.
In consideration of the granting ofthis requested,permit,I do hereby agree,that l.will,in all respects„perform the work
in accordance with the approved.plansi the Florida.Building.Codes and St.Lacie County Amendments.
The"foilowing building permit applications;are.exemptfrom undergoing a fulGconcurrency rev ew:'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.mayresult in paying twice for
improvements to your property.A Notice-of Commencement must be rec ded in the public records of St:
Lucie County and posted on the jobsite before the frst inspecticn.lf you end to obtain financing, consult
With:Ienderoranattorne beforecommencin .work`orrecor " . iSY `oureofCommencement.
S ature of O r Lessee/contractor.as:Agent for Owner Si e.of.-Cont ctor/Lic nse Holder'
STATE OF FLORI ,STA E OF.FLQ
COUNTY OF Q, , COUNTY OF V
Sworn to(or affirmed}and;subscribed before me of Sworn to(or'affirmed)andsubscribed before me of
x Physical Presence or. Online Notarization . x PhysicaLPresence.or' Online Notarisation
thNs 22nd day of.May 2020 by this 22nd day;of may 2020 by
Name of person making statement. Name:of personmaking,statement.
Personally Known x OR Produced Identification Personally Known x OR Produced'Identification.
Type of Identification_ Type of Identification.
Produced,. A Produced
Ul
-� _ KERRI ANN FU U.TR 1
`$° 'otar Public:State of:Florida
(Signature o ota a ;�f Flib�'itla G'32255& (Signature of Notary Pu fie- t e ida} KERRIANN uPTR i.
% opn°j' 'My ohm.cx,.ire Apr 1,2023' = t P bl a o"riari
No ary u tc Stat �.
rough h Gora'hbtary.Assr. "/��� /fin r 5tK c Ca mission GG 322558
Commission;No. Commission.No1✓t t JCS FEE �m..E x Tres A r a r,20.3
Bonded through Natibna:hdtary'As r'.
REVIEWS FRONT ZONING SUPERVISOR PLANS: VEGETATION. SEA TURTLE MANGROVE
COUNTER: REVIEW REVIEW' REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
�ev.S/6120