HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONa;
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i• �� �� Permit Number:
3CANNED
Y. BY
St Lucie County RECEIVED
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
PERMIT APPLICATION FOR: Mobile home
PROPOSED IMPROVEMENT'LOCATION.
Address: /0701 _5 C�G'�-- :V� W
Legal Description: VENTURE OUT AT INDIAN RIVER INC
Property Tax ID #: 4511-510-0048-000-5
Site Plan Name: �
Project Name: �— /J I S66L
Setbacks Front 10 L.;Back: f r:9.
JAN 1 1 2018
ST, hucle County, Pcmm�lt5ing
Residential X ~-
Right Side: 11 3-23 LeftSide: i
Lot No. 847
Block No.
I: D;ETAIL-ED DESCRIPTION OF WORK:
NEW 2018 MOBILE HOME
CONSTRUCTION INFORMATION:
�ciclitional work to a performed under this permit —check a apply:
L�' IHVAC Ei Gas Tank ®Gas Piping _ Shutters a Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 2475 Utilities: Sewer []Septic Building Height: 13
OWN /LESSEE:
CONTRACTOR:
Name O 1 l /�/__' - 13 �
Address vl_
Name: f
Company:
'� rrTOMS MOBILE HOME
Address: Lv` t2 c) r
City: Mj ) G�-- State: CT
Zip Code. 34957 Fax:
City: `jf—C LOB State: FL
Phone No. �11� tbd�— �3"i
Zip Code: 34772 Fax:
E-Mail:
Phone No. 8635292370
Fill in fee simple Title Holder on next page (if different
E-Mail: NANCYARMSTRONG61 @GMAIL.COM
from the Owner listed above)
State or County License:`I
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
"c.
.SUPPLEMENTAL CONSTRUCTION LIEN LAW LNFORMAT.ION,:
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF-LUCIE
COUNTY OF-LUCIE
The forgoing instrument was acknowledgg before me
The forgoing instrument was acknowledgqoefore me
this 4 day of JAN 20 I by
this 4 day of JAN 20 ( by
EDDIE GRUNDEL
EDDIE GRUNDEL
Name of person making statement
Name of person making statement
Personally Known x OR Produced Identification x
Personally Known x OR Produced Identification x
Type of Identification
Type of Identification
P duced FLDL
Produced FLDL
11 PA UvL�-�
6'a �,&U._�
(Sign ture AlLtary Public- State of Florida)
(Signature of Nc to Public- NG
MIMS ARM
eal) __
Commission No :�''R'""��?,+•
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tev.8/2/17