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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �PLICABLE yt` aA �( SCANNED Permit Number: BY ° ��° I'TUG 2 3 2016All 0 Building Permit Application ing and Development Services O hg and Code Regulation Division Virginia Avenue, Fort Pierce FL 34982 ie: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X PERM, IT APPLICATION FOR: Mobile home PROPOSED IN 4PROVEMENT LOCATION: Addrll ss: 524 NETTLES BLVD Lega' Description: NEETTLES ISLAND INC A CONDO SECTION II PARCEL Pro lerty Tax ID #: 4502-501-0710-000-1 Lot No. Site Plan Name: Block No. Project Name: _ Set ll acks Front /�� Back: Right Side: Left Side: DE; AILED DESCRIPTION OF WORK: 7 DOUBLEWIDE MOBILE HOME CQNSTRUCTION INFORMATION: itiona work to e nerformed under this permit — check a pp ay: !W✓ HVAC0 Gas Tank Gas Piping M_ Shutters a Windows/Doors Electric ❑✓— Plumbing Sprinklers O Generator 0— Roof T tal Sq. Ft of Construction: C Ist of Construction: $ 2475 S Ft. of First Floor: _ Utilities: Sewer Septic Building Height: 13' ' .WN ER/LESSEE: CONTRACTOR: f 'al me EMILY FIGUERO Name: THOMAS GRUNDEL I,11 ddress: 765 SHORE RD APT 28 Company: Tom's Mobile Home Set-up ty: LONG BEACH State: NY Address: 4433 HENRY J AVE ip Code: 11561 Fax: City: SAINT CLOUD State: FL ;i (hone No. 516-667-8966 Zip Code: Fax: E-Mail: Phone No. 863 529 2370 armstron 61 E-Mail: nanc Y 9 @9mail.com dill in fee simple Title Holder on next page (if different Irom the Owner listed above) State or County License: IH1025148 value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPL MENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: 11 _ Name: Addres ''• Address: City: State: City: State: Zip: I Phone: Zip: Phone: FEE SI "PLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable _ Name: 'l Name: Addres' t Address: City: �`I City: Zip: Phone: Zip: 1I1 Phone: no work or installation has commenced prior to the issuance of a permit. St. LuciJ'[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 consi eration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work i in acco dance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The foil{ wing building permit applications are exempt from undergoing a full concurrency review: room additions, accessi lry 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 impro'' ents to your property. A Notice of Commencement mus a ecorded and posted on the jobsite befor the ' st inspection. If you intend to obtain financing, con It w' h lender or an attorney before coin encing or or r ordine vour Notice of Commencemen . _ Sign Itu f wner/ Lessee/Agent 1gnatufe of Contractor/License Holder STAT OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF STLUCIE i The f ,,Irgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this ;, day of 20 _by this 15 day of 'uLr , 20 by THOMAS GRUNDEL (Nam " of person acknowledging) a of person acknowledging i i (Sign" II ture of Notary Public- State of Florida) (Sig ature N ary Public- State of Florida ) Pers Ihally Known OR Produced Identification Personally Known x OR Produced Identification Type i f Identification Produced Type of Identification Produced FLDL ;•'!'s"� NANCY RMSTRONG Com Ission No. (Seal) Commission No. t3I@fa9f MY COMMISSION # FF197899 07/15/2014 IIIIEWS RE FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DA E CO ', PLETE INIJALS tA&4-[e_5 _ Not Applicable ame: Iddre ,ty; State• p: Phone SIMPLE TITLEHOLDER: _ Not Applicable Jdress: ty: p: Phone: - MORTGAGE COMPANY: _ Not Applicable Name - Address: City: _State: Zip: Phone: BONDING COMPANY: " _Not Applicable Name: Address: City: Zlp: Phone: WNERJ CONTRACTOR AFFIDVIT: Application -is hereby made.to obtain permit to do the work and installation as indicated. certify that no work or installation has commenced' prior to the issuance of a permit.. Lucie Countv makes no representation that isgranting a permit; will authorize the permit holder to build the subject structure rucctturenPleassle consult with Home Ow.e s Asso at on and rules, ev ewyyour deed for any resNictionswhich may Oprohibit such consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. ie following building permit applications are exempt from undergoing a full concurrency review: room additions, :cessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use 1ARNING TO OWNER: Your failure to Record a Notice'of Commencement may result in your paying twice for nprovements to your property. A Notice of'Commencement must.be.recorded and posted on the jobsite afore the Irst inspection. If you intend to obtain financing, consult wi /lender oranI a/torney-before _s�i• ..L _ .-."."1..- .• A1.�+7ro ref r^mmanrar"Ant J / // U CUIIIIIICII to Ict-WUMF, Y%J%Al \VLlY4. V• �•••••• ••__... _.___ `�1r114yV,VV�Uhn 41 � 1�•� h''-�'a'LY 5 ature of Owner/ Lessee/Contractor as Agent for owner i ature of contractor/License Holder STATE OF FL O�' R.�D�i; STATE OF FLOR COUNTYOF _'' COUNTY OF The forgoing lnstru entwas acknowledge before -me 20JV by The for oing instr-u ent,was acknowledg d//bbefore me this day of 261 (Oby this .� day of A eA 1 qa.!5 Or"(Je-1 (Name of person acknowledging) (Name;of person:acknowledging ) (Signat re.of No PubliState of Florida }• ( nature of Notat ub4lic-State of Florida Personally Known OR Produced Identification I Personally fCnow Type ofldentifica i " NANCY MIMS ARMSTRONG Type of ep t I MIMS ARMSTRONG ProduceAN Produced '•'= ON # FFISTS99 .COMMISSION # PF197899 Commis ioT` EXPIRES February 10(Wo EXPIRES February W1 20tO Commission No. •'"` Fioridallota j;iMIICNwin (407)39r �3 FloridallotaryServke.0an - REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 772014 a