HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / ,/
Date: lf�' �' 7 Permit Number: 1 7OI//G-0 V��11T
J
RECEIVED
Building Permit Application
Planning and Development Services JUNN
/ 2017
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IIUIPR01/EMt'NT LOCATI.C}N k
Address: ��1q� 171G L {wSo"r 1 C 2 i PO 12-7— S'rL_VC�L: r
Legal Description:
Property Tax ID#: 41 79(o — 06cC -- Mb—F Lot No.
Site Plan Name: 2TL Block No.
Project Name: �GV12T'Z
Setbacks Front Back:_&4 Right Side: t - Left Side:
t-<
DETAILED DESCRIPTION OF WORK
� i�Go►2►71/j-G�
CONSTRUCTION INFORMaTlON t
Aaartional work toe,nertormed un er t is permit—check all appy:
❑HVAC _Gas Tank []Gas Piping _ utters F]Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$�?Q7.00 Utilities:cn Sewer F-1 Septic Building Height:
C+VIINER/LESSEE + ' CONTRACTOR Fy
..... :a. , x , .., d ..
.,
Name Ky2rZ 1 C,&4n-n 4,SV$Ao,, Name: MICHAEL GOODWIN
Address:(,, 7G'►Y 171GIL 1r,!S IN_j EYL_ Company: JENSEN BEACH ALUMINUM
City: To✓tX— ST "C'1G State:� Address: 1720 NW FEDERAL HWY
Zip Code: Fax: City: STUART State:FL
Phone No. 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.
.�� u. , . .. LAW INFORMATION _PPLEMNTAL CQNSTRUCTION IIIU Sl
M..
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:Your fa
' ure to Record a Notice of Commencement may r sult in your aying twice for
improvements to your pr e A Notice of Commencement must be reco d and o d on he jobsite
before fir inspectI u intend to obtain financing, consult w der or n for before
com nci ork r r our Notice of Commencement.
Signatur of IOWYLYXesgie ontractor as Agent for Owner Signature o Con actor is n Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF _,�37— COUNTY OF Si (>C1F
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thi,V?z)bday of20/,,"by this���day of �"C�,UF 20/7 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of1T=ry Puub ic-State o PIorlda) (Signature ary Public-`Slate of Florida)
Personally Known ✓ OR Produced Identification Personally Known/�OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. !-- ? UMOND Commission No.
,,y...•••��, .o..-..yP�., A 1N M. AUMOND
MY COA4MISSION#FF 173907 MY COMMISSION#FF 173907
_ - December 7,2018
Bonded Thru Nota! Public Underwriters '"Mr.4yq ' Bonded Thni N
Diary Public Urdenvr ters
Revised 07/15/2014-`.--
REVIEWS
7/15/2014-`REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS