HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
0 - FIECENED
Building Permit Application JUL 2 0 2021
Planning and Development Services
Building and Code Regulation Division Commercial Residential XX—I g-
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: MOBILE HOME
Address:
Property Tax lD #: ,
Site Plan Name: ,,,,
Project Name: �gaq
New Electrical Meter Second Electrical M
Additional work to be performed under this
✓Mechanical _ Gas Tank _
(/lectric _lumbing 1
Total Sq. Ft of Construction:
Cost of Construction: $ 15
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it — check all that
Piping
Sprinklers
Lot No.
Block No.
fyGtters _ Windows/Doors _ Pond
Generator _ Roof Pitch
Sq Ft. of First Flo r:
Utilities _ Sewer Septic Building Height: T "f
0UIINERjL`ESSEE `§z
TCONTRACOR
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Name 141
Name•EDDIE GRUNDEL
Address:
Company:TOMS MOBILE HOMES
Address:4460 BRADY RD
City: Is State:
Zip Code: Fax:
City: ST CLOUD State: FL
Phone No.
Zip Code: 34771 FFa'x:
E-Mail:
Phone No �/ 0 —%Q�—/T u
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E-Mailnancyarmstrong6l@gmaii.com (�
Fill in fee simple Title older on next page ' different
from the Owner listed above)
State or County License IH11184697
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.
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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 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.
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIPA
STATE OF FLORIDA
COUNTY OF
COUNTY OF (Z5
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and st,Kcrribed before me of
�Physical Presen or Online Notarization
Physical Presence or Online Notarization
tlfis'_�', ay of 2020 by
this etn day of Tune 2020 by
PDDI-f— at-w-2d'd
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Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known - OR Produced Identification
Type of Identification
Type of Identification
Produced
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ProducedoL
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(Signature of Notar ublic- State of Florida)
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signat re of Nota Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
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ate of Florida
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