HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR AIPPLICATION TO BE ACCEPTED '
Date: Permit Number: ISO 3J
MANNED
• - RE
Building Permit Application MAR-2-0 201a
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mobile home
J ,PROPOSEQ IMPROVEMENT. LOCATION
Address: I � `1 11_v_�k kl j
Legal Description: NETTLES ISLAND INC
Property Tax ID #: #50A .D I- o3aS- D06, -S-
Site Plan Name:
Project Name:
Setbacks Front_ Back:aa_ RightlSide: Left Side: 9
DETAILED-DESGRIPTION:OF WORK
NEW 2018 MOBILE HOME
Lot No. 3
Block No.
CONSTRUCTION INFORMATION.
Adclitional work to e e orme un er this permit —Ic ec a apply:
RjHVAC E] Gas Tank 0Gas Piping _ Shutters Q Windows/Doors
I
a Electric 0 Plumbing Sprinklers []Generator Roof u Roof pitch
Total Sq. Ft of Construction: I S . Ft. of First Floor:
I
Cost of Construction: $ 2475 Utilities: Sewer Septic Building Height: 13
I
.OWNER/LESSEE
CONTRACTOR. _: ti
Name (U.,
Name:
Address: I
Company: TOMS MOBILE HOME
City: State:
Address _q%O s.A 1414-1
Zip Code: 34957 Fax:
City: C�iuu-�c State: FL
Phone No.
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: IH1118467
IT vaiue of construction is 5Z5oo or more, a RECORDED Notice of Commencement is required.
i
,SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: _
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State: iCity:
State:
Zip: Phone I
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 Buildirig 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 acknowledg d before me The forgoing instrument was acknowledge before me
this 4 day of lAN 20 by this 4 day of JAN . 20 by
EDDIE GRUNDEL EDDIE GRUNDEL
Name of person making statement I 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
Produced Fldi Produced Rd
[S'ignatde of No a Public- State of Florida 0 (Signature of N t ry Public- State of Florida )
Commission No. (Seal) Commission No. (Seal)
NANCY MIMS
3AR
'ANCY MIMS RMS
TES P REVIE% SUPERVISOR fsl 0' MANGROVE
REVIEW RE RsFeb aREVIEW
DATE Horidallota
icexom
RECEIVED
DATE
COMPLETED
Rev. 8/2/17