HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE IN - g— ) L-
FO MUST BE COMP.-FLD FOR APPLICATION TO BE ACCEPTED '
Date. _/J / Permit Number: 1,5 W/
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: To Select from dropbox, click arrow at the end of line
PROPOSED] MPROVE M'E,NT LOCATION;:
Address: 10725 S OCEAN DR 362
Legal Description: HOLIDAY OUT AT ST LUCIE - SEC B BLK R LOT 7 AND EQUAL PRO-RATA INTEREST IN COMMON ELEMENT'S (OR 3193-1390)
Property Tax ID #: 4511-502-0160-000-1
1''
Site-Ptan,,Name:
Project Name: KLIMOVICH
Setbacks Front Back:
DETAILED`DESCRIPTION OF WORK
Right Side: Left Side:
2015 NEW MOBILE HOME REPLACEMENT 21'8X35/36
Lot No. 362
Btock No.
CONSTRUCTION: INFORMATION:
Additional work to e nertormed under this permit -check
✓❑— HVAC Gas Tank ❑Gas Piping
all
apply:
_ Shutters
Q Windows/Doors
Electric ❑✓ Plumbing
OSprinklers
El Generator
Roof
Total Sq. Ft of Construction: 773
Cost of Construction: $ 2475.00
Utilities:
S Ft. of First Floor:
Sewer Septic
Building Height: 13'
OWNER/(ESSEE: =
CONTRACTOR:`
Name Victor or Anna Marie Klimovich
Name: THOMAS GRUNDEL
Address: 16 Surrey Dr
Company: TOM'S MOBILE HOME SETUP
City: Hazlet State: NJ
Address: 3344 HENRY J AVE
Zip Code: 07730 Fax:
City: ST CLOUD State: FL
Phone No.
Zip Code: 34772 Fax:
E-Mail:
Phone No. 407-908-5468
Fill in fee simple Title Holder on next page ( if different
E-Mail: nancyarmstrong6l@gmail.com
from the Owner listed above)
State or County License: IH1025148
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUP'PLEMtNTAL°CONSTRUCTI(s E' 'N LAW. IN FORMATION:
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:
ZTp: Phone:
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 Fl Wa Suilding Codesand 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before first inspection. If you intend to obtain financing, cons Ith lender or an attorney before
comm ncin work or recording vour Notice of Commencemen
_ S/gnature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF 3L1UC1e
The forgoing instr nt was acknowledged �re me
this � day of 20 -by
Thomas Grundel 1
(Name of person acknowledging)
re of Lontractoriucense
STATE OF FLORIDA
COUNTY OF stiucie
The forgoing instrument was acknowledged before me
this 23 day of ju,e 20 by
Thomas Grundel
re of/Notary Public, tate of Florida ) -J I (S
of person acknowledging)
Public- State of Florida )
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identificati ,CU
'
e My CONRAIS��tnFF197899
Commission No �-�.......($e Commission No. ' .� c lr;l-S F br laiv 10, 2019
.Jr
STRONG
EXPIRES February 10, 2018
Revised 07/ 14 3
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