HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL A PLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date1 -a% d Permit Number:
C �oq2
_-- _-- cl� � R ECEIVE®
Building Permit Application i
Plan `ng and Development Services c - y O E P ' ` �$
Build'I ig and Code Regulation Division
2300 lir inia Avenue, Fort Pierce FL 34982 i , i-ucie County, Permittin
Pho _ fie: (772) 462-1553 Fax: (772) 462-1578 Commercial � utRRe�dMial x 9
PERMIT APPLICATION FOR: Mobile home
Addre''s: ''yG o4" _W;%A '' *.'%\ %a wk b f
Legal escription. Lot 23 in Block 70 of Fairways At Savanna Club Replat No. 1
Propeil ty Tax ID #: 3424-800-0093-000-5 Lot No. 23
Site PIn Name: Block No. 70
Proje Name: 2-10 8.4
Setba ' ks Front W Q Back;,;5' Right Side-ol-O' Left Side: 7.5
Mob4 Home Setup with plumbing, electrical, and mechanical
CON
YTRUCTION INFORMATION
Addit
RjHVAC
:)nal work to be nertormed un er t is permit- check
Gas Tank ❑Gas Piping
a
app y:
Shutters
a Windows/Doors
LJ
_
Rlectric
IJ
Plumbing
Sprinklers
ElGenerator
Roof Roof pitch
Total
q. Ft of Construction: 1 a-, I �J
• y
i
S . Ft. of First Floor:
Cost o
Construction: S 5,000.00
Utilities:0Sewer 0Septic
Building Height:.
01NNER%LESSEE
CONTRACTOR:
Name
Addreiouthfield
City:
Zip C
Phon
E-Ma
Fill in
from
0avanna Eagles Retreat LLC
Name: Thomas G. Jennings
Company: Jennings Mobile Home Setup, LLC
Address: P O Box 1428
City: Auburndale State: FL
Zip Code: 33823 Fax: 863-967-6655
Phone No. 863-965-0883
E-Mail: jenningsmhs@tampabay.rr.com
State or County License: IH1025176
s: 27777 Franklin RD Ste 200
State: MI
Ide: 48034 Fax:
No.
: cmerrifield@suncommunities.com
ee simple Title Holder on next page (if different
a Owner listed above)
If valuo of construction is $2500 or more, a RECORDED Notice of Commencement is required. i
I
SUP
LEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESI
Name:
Addr
City:
Zip:
NER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
ss•
Address:
City: State:
Zip: Phone:
State:
Phone
I
FEE SIMPLE
Nam:
Address:
City: iii
Zip: 11
TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Phone:
Zip: Phone:
OWNEIIR/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certif r that no work or installation has commenced prior to the issuance of a permit.
St. Lud County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which i in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structu 'e. 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 accoidance 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
WAR ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impro ements to your property. A Notice of Commencement must be recorded and posted on the jobsite
befor(! the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencin work or recording our Notice of Commencement.
Signal:lure of Owner/ Le ee/Contractor as Agent for Owner Signature of Contra or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Polk COUNTY OF Potk
The forgoing instrument was acknowledged before me
this 1 th day of September , 2018 by
ThomO6 G. Jennings
11 Name of person making statement
Personally Known x OR Produced Identification
Type Iof Identification
Prod �i d
)41� —'JV_
(Sign ture of otary P ic- lfla,d,,�,.�,.,
KIMBERLYWATKINS
Com Mission No. �: :;4 (8&)INISSI0NNFF184770 t
Bonded ThuNotaryPubllc nd Bnariitters
The forgoing instrument was acknowledged before me
this 14th day of September , 2018 by
Thomas G. Jennings
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Produced
of Notary
mmission N
KIMBERLY WATKINS
(Se.Wg VIOSISSION # FF 184770
EXPIaaES: January 7, 2019
Bunded Thru Notary Pubric Underwrite
REV�EWS FRONT ZONING SUPERVISOR PLA VEGETATION - SEATURTLE MANGROVE
COUNTER REVIEW REVIEW RE REVIEW REVIEW REVIEW
DATgl
RECEIVED
DAT
COMPLETED IY141 11�
Rev.8/2/17