HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:- y l ��t Permit Number:yjib j-OU q 3
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Building Permit Applicatio APR 18 'rq
Planning and Development Services ST LucieCeunty Perr�rttfn
Building and Code Regulation Division _ _ 9 ..
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X nnA
PERMIT APPLICATION FOR: Mobile home
1-,PROP,OSED IMPROVEMENT LOCATION:.. Ilf
Address: 138 NETTLES BLVD
Legal Description: NETTLES ISLAND INC, ACONDO-SECTION II PARCEL 138 ANDPRO-RATA SHARE IN COMMON ELEMENTS (OR 3378-178)
PropertyTax ID #: 4502-501-0324-000-8 Lot No.
Site Plan Name: Block No.
Project Name: HOLLOWAY PERMIT
Setbacks Front Back: Right Side: Left Side:
'DETAILED DESCRIPTION`.OF WORK
MOBILE INSTALL20X35/39 Aft jr1�tcliziC T-4-
��eS 11,6Bd`�
CONSTRUCTION' INFORMATION:
AdClItionalworl(tobe errormed uerer n t Ispmd—c ec a appy:
RHVAC Gas Tank ❑Gas Piping In _Shutters L]Windows/Doors
Electric 21Plumbing Sprinklers 11 Generator Roof Roof pitch
Total Sq. Ft of Construction: 740 SFFtt.� of First Floor:
Cost of Construction: $ 1 L-II Y7s Utilities. LCJ Sewer El Septic Building Height:
OWNER/LESSEE.
CONTRACTOR:
Name Howard R Holloway Amy Holloway
Name: EDWARD GRUNDEL
Address:9346 Nugent TRL
Company: TOMS MOBILE HOME SETUP
City: WEST PALM BEACH State: FL
Zip Code: Fax:
Phone No. 5617188315
Address: 4460 BRADY BLVD
City: SAINT CLOUD State: FL
Zip Code: Fax:
Phone No. 863-529-2370
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: NANCYARMSTRONG61 eGMAIL.COM
State or County License: IH1118467
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAN/ INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Howard R HdlawayAmy Holloway Name: EOW FID CRUNDEL
Add re SS: lie NETTLES BLVD Address: 9346 NugentTRL
City: WEST PALM BEACH State: City: SAiNT CLOUD State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address: 4460 BRADY BLw
City:
Zip: Phone:
BONDING COMPANY:
Address:
City:_
Zip:
_Not Applicable
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 1 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
cnmmpncing work or recording vour Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agentfor Owner
SignaturKof Contra ctor/License Holder
STATE OF FLO Ip A
STATE OF FLORf��D
COUNTY O d���(A n t�
COUNTY OF�Y�
The f oing instru s acknowledg efore me
this yn day of 2101_^ bby
The forgoing instru nt as acknowledg efore me
this � day 20 by
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Name of p erson5Wm statement \
Name of person g statement '1�(/
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Personally Known ✓ OR Produced Identification
Personally Known OR Produced Identification
Type of IdentiRga ion
Type of Identification
Produced
oduced�
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Rev.8/Z/17