HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u
Date: �� Permit Number:
RECEP.'^D APR 19 7917
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
PROPOSED IMPROVEMENT LOCATIOi� F
Address: 9628 ENCLAVE CIR, PORT ST LUCIE
Legal Description: 3322-800-0011-000-4 ENCLAVE AT THE RESERVR LOT8 (OR 3723-1219:3859-824)
'Property Tax ID#: 3322-800-0011-000-4 Lot No.
Site Plan Name: GOSCHKE Block No.
Project Name: GOSCHKE
Setbacks Front NIA Back: N/A Right Side: NIA Left Side: N/A
DETAILED DESCRIPTION OF WORK #z '"
- �w , �. .
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WINDOW REPLACEMENT(5 OPENINGS / IMPACT)
CON
5TRUCT>I..0N INFORMATION-:
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Additionalwork to be erformed under this permit—check all appy:
11HVAC Gas Tank Gas Piping _Shutters ZWindows/Doors
Electric ❑ Plumbing Sprinklers 11 Generator E] Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction: $ 18,068 Utilities:]Sewer D Septic Building Height:
OWNER/LESSEE CONTRACTOR£
Name GOSCHKE Name: MICHAEL GOODWIN
Address:9628 ENCLAVE CIR Company: JENSEN BEACH ALUMINUM
City: PORT ST LUCIE State:FL Address: 1720 NW FEDERAL HWY
Zip Code: 34956 Fax: City: STUART State:FL
Phone No.772-828-0034 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.
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"SNTAL CC)NSTFtI�CTIC}N RIIL! LAW INaRMATION
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 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:Yo r f it re to Record a Notice of Commencement may result in r paying twice for
improvements to your o r A Notice of Commencement mu ecoonraVattorney
ted on the jobsite
before t rst ' spe to . I u intend to obtain financing, co suit th before
comm ci rk r o our Notice of Commencem t.
s
Sig ature of Owner/Lesse ontractor as Agent for Owne Signature of Contractor License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STT COUNTY OFA )("/'�g
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
t4& day of20jy this vWtlay of� 2017 by
162
(Name of person acknowledging) (Name of person acknowledging)
(Signature-or-Notary blit-Staff"Florida) (Signature o otar_y.Public-State of Florida)
Personally Known ----'OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Commission No. (Seal)
:Na ANN M.GAUMOND
MY COMMISSION#FF 173907 ,oIlk
: 4, ANN M.GAUMOND
a'•. EXPIRES:December 7,2018 :+; :� ISSION#FF 173907
°P4 Bonded Thru Notary Public Underwriters 3 EXPIRES:December 7,2018
Revised 07/15/201 " p Bonded Thru Notary Public Underwriters
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS