HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U
Date: �:3 '�'� Permit Number:
RECEI!''D MAP, 2 3 7017
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line S1%x) �S
PROPOSED IMPROVEMENT LOCATIO'N:
Address: 1202 NW WINTERS CREEK RD
Legal Description: HARBOUR RIDGE PLAT17 TRACT G-10 AND PINE VILLAGE LOT 2(OR 1529-1982)
Property Tax ID#: 4423-701-0006-000/5 Lot No.
Site Plan Name: HESCH Block No.
Project Name: HESCH
Setbacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
DETAILED DESCRIPTION OF WORK:
HURRICANE SHUTTERS ( 7 OPENINGS / PANELS )
CONSTRUCTIONINFORMATION: -
Additional work toe e orme un er t is permit—check a appy:
HVAC E]Gas Tank []Gas Piping _Shutters ❑Windows/Doors
❑Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction: $ 4000.00 Utilities:Sewer[]Septic Building Height:
OWNER/LESS'EE �� ,CONl"RACTQR:_
Name DONALD J HESCH Name: MICHAEL GOODWIN
Address:1202 NW WINTERS CREEK RD Company: JENSEN BEACH ALUMINUM
City: PALM CITY State:_ Address: 1720 NW FEDERAL HWY
Zip Code: 34990 Fax: City: JENSEN BEACH State:FL
Phone No.336-4999 Zip Code: 34994 Fax: 692-9744
E-Mail: Phone No. 692-0090
Fill in fee simple Title Holder on next page (if different E-Mail: MICHAELLGOODWIN@YAHOO.COM
from the Owner listed above) State or County License: CGC 1508437
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTALICONSTRUCTION.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:
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 thepermit 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 Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from ndergoing a full concurrency review:room ditions,
accessory structures,swimming pools,fences,walls,sign ,screen rooms and accessory uses to anoth non-re ' ential use
WARNING TO OWNER:Your fAre R or a Notice of Commencem Sul yo aying twice for
improvements to y0 r prop Ic of Commencement mus e r de d sted on the jobsite
before the ' s .ins ction. yto obtain financing, co It en attorney before
comme In or r re diotice of Commencem t.
S
Signature orOwner/LessdELcontractoras Agent for Own Signature of Contract cense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF <S—r --IC COUNTY OF .S' r_11�
The for o' instrument was acknowledged before me The forgoing instrument was acknowledged before me
thip�7'�/ y of �i,NLdf 201 by th;,5%2'v/?ay of �iVifC_& ,20/r by
(Name of person acknowledging) (Name of person acknowledging)
Sig •arum-af Notar u lic- ttafe of Florida) (Sign Notary blic-State of Florida)
Personally Known i/ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. I ;J'a•. A( �h,AUMOND Commission No.
'r' MY COMMISSION#FF 173907 ,o:;Y°GgE i ANN M.GAUMOND
*: +_
y. ' EXPIRES:December 7 2018 = :¢: MY COMMISSION#FF 173907
' s ca? Bonded Thru Notary Public Underwriters ^' o` EXPIRES:December 7,2018
Revised 07/15/201 �4' Bonded Thru Notary Public Underwriters
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS