HomeMy WebLinkAboutBuilding Permit ApplicationF"
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -1 1 �� Permit Number: -�� d 3� do4 y
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Building Permit Appl
Planning and Development Services , N'm _ V C��Vr U�l1L�P d—p
Building and Code Regulation Division 1 j.�� V -
2300 Virginia Avenue, Fort Pierce FL 3498Z—
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
MAR 0 4 '_019
Residential x
BY
St. Lucie (
P R : MOBILE HOM w, -� hk
PROPOSED IMPROVEMENT LOCATION: "
Address: 2164 NETTLES BLVD
Property Tax ID #: 4502-501-0167-000-9 Lot No.164
Site Plan Name: ALBERT SCHROTH Block No.
Project Name: SCHROTH
DETAILED DESCRIPTION OF WORk:
NEW MOBILE HOME REPLACEMENTIOX38/50 jtU L \ \ 8 Q AN
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
V echanical /Gas Tank _Gas Piping _Shutters —Windows/Doors
Ylectric rv7 Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. f First Floor:
Cost of Construction: $ Q �O Utilities: Sewer _Septic Building Height: 14"
OWNER/LESSEE:
CONTRACTOR:
NameALBERT SCHROTH
Name:EDDIE GRUNDEL
Address:2164 NETTLES BLVD
Company:TOM"S MOBILE HOMES
City: JENSEN BCH State: _
Zip Code: 34957 Fax:
Phone No.772-229-6102
Address:4460 BRADY RD
City: ST CLOUD State: FL
Zip Code: 34772 Fax:
Phone No407-709-1490
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailnancyarmstrong6l@gmaii.com
State or County License IH1118467
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
4
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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, 1 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN A ORNEY BEFORE 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 ST LUCIE
COU NTY OF sT LUCIE
The forgoing instrument was acknowledged^before me
this 5 day FEBRUARY 2QJ4 by
The forgoing instrument was acknowledged before me
this 5 day of FEBRUARY 2Q'/--/N- by
of
' 1
EDDIEGRUNDEL
EDDIEGRUNDEL
Name of person making statement.
Name of person making statement.
Personally Known X OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced DL
ProducedDL
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(Signat re of N to ublic-3ftWMm ffitida3 y 10, 2019
Signature of N i`ibli3- LP0441&tdaa)y 10. 201
(a 13& i3 rbrulalloarySercze.con,
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Commission No. ea
Commission No.
REVIEWS
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ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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DATE
RECEIVED
I
DATE
COMPLETED
Rev. 2/7/19