HomeMy WebLinkAboutBUILDING PERMIT APPLICATION completedAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/3 1/2022 Permit Number: ---------
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential ✓ -----------2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding ___ _
PERMIT APPLICATION FOR:
---------------------------
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID#: 1433-210-0003-000-9
Site Plan Name:
Project Name: Mobile Home Set Up
Lot No. ----
Block No. __ _
Setting a mobile home on the property address listed above in the commmunity of Tall Pines
New Electrical Meter __ ✓� __ Second Electrical Meter ______ (Affidavit required)
Additional work to be performed under this permit-check all that apply:
_Mechanical
Electric
Gas Tank
_ Plumbing
_ Gas Piping
_ Sprinklers
Shutters _ Windows/Doors
Generator Roof ----
Pond
Pitch
Total Sq. Ft of Construction: _1_3_0_6 ____ _ Sq. Ft. of First Floor: _________ _
Cost of Construction: $ - �---- Utilities: ':/. Sewer _ Septic Building Height: _3 _6_' __ _
OWNER/LESSEE: CONTRACTOR:
Name Inspire Communities -Granite Tall Pines
Address: 47 42 N. 24th St. STE 325
Name: Samuel Taromino Ill
Company: Champion Home Builders INC
City: Phoenix State: AZ Address:1424 Hamlin Ave Unit I
Zip Code: 85016 Fax:________ City: St.Cloud State:£!:_
Phone No. 916-792-5315 E-Zip Code: 3477 1 Fax: ______ _
Mail: Phone No 407-556-3 807
Fill in fee simple Title Holder on next page (if different E-Mail kking@superiorrestollc.com
from the Owner listed above) State or County License�l�H�-�11�2=7�5�3 =2�------
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.
83,535
129 N Erie Dr Fort Pierce FL 34946 (Part 33-34-40)
129
Registration # 32818
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _y Not Applicable MORTGAGE COMPANY: __y Not ApplicableName: Name: Address: Address: City: State: --City: State: --Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: L 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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit suchstructure. Please consult with your Homeowners 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 I er or an attorne before commencin work or recordin our Notice of Commencement.
Signature of Contractor -or -Owner Builder as applicable ·"· . ' STATE OF FLORIDA COUNTY OF t;:;;{::iL�\ �
Sworn to (or affirmed) and subscribed before me of
this i day of '\-��\\.'3('>.\.. '\ , 20� by
__j_ Physical Presence or __ Online Notarization
Name of person makiniy;tatement.
Personally Known_✓ __ OR Produced Identification
Type of Identification Produced __ -=----------
Commission No.\.\\-\() "l'Yloql\(Seal)
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