HomeMy WebLinkAboutpermit application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 1 y l DU 0) 1
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 X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRQPOSED IMPROVEMENT LQCATION
Address: 10044 S OCEAN DR#402 JENSEN BEACH, FL 34957
Legal Description: SEA WINDS CONDO APT 402(OR 846-2445: 1627-2152)
Property Tax ID#: 4502-804-0026-000-9 Lot No.
Site Plan Name: MACK Block No.
Project Name: MACK
Setbacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
DETAILED DESCRIPTION OF WORK
WINDOW & DOOR REPLACEMENT (6 OPENINGS)
WINDOWS (2 OPENINGS IMPACT)
DOORS ( 4 OPENINGS WITH EXISITING SHUTTERS (SLIDING))
CONSTRUCTION INFORMATION
Add
itiona wor to e e orme under this permit—check a appy:
HVAC Gas Tank Gas Piping _Shutters Windows/Doors
❑Electric ❑ Plumbing Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction:15,500.00 S Ft.of First Floor:
Cost of Construction:$ Utilities: _Sewer 0 Septic Building Height:
OWNER/LESS'EE ;CONTRACTOR
,,.
Name THOMAS W MACK Name: MICHAEL GOODWIN
Address: 100044 S OCEAN DR#402 Company: JENSEN BEACH ALUMINUM
City: JENSEN BEACH State:_ Address: 1720 NW FEDERAL HWY
Zip Code: 34957 Fax: City: STUART State:FL
Phone No.692-0090 Zip Code: 34994 Fax: 692-9744
E-Mail:michaellgoodwin@yahoo.com 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAUD INFQRNIATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: STEVENMORAGA Name:
Address:100044 S OCEAN DR#402 Address:
City: JENSEN BEACH State: Fl_ City: State:
Zip: 34957 Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not IApplicable 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,t ori Building Codes and St.Lucie County Amendments.
The followi Wuild'np�rrmtIons are ex mpt from undergoing a full concurrency revie :ro m additions,
accessory tru ,fences,w IIs,signs,screen rooms and accessory u s to no ernOn-residential use
WAR NG Ture to Re ord a Notice of Commenceme t y r ul n your paying twice for
impr veme Commencement t r or d d posted on the jobsite
bef e u intend o obtai financing ons I i le er r an attorney before
co mencinour No is ommence ent.
s
Signature ofOwner/Less Contractor as Agent for Owner Signature of Contractor/ ice se Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SZ: COUNTY OF 5'T
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thi ?�day of 20 j�rby thy / day of T Ue-)` 20 / by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature Notary Public-Stateof`FTorida)
Personally Known /OR Produced Identification Personally Known ,✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. -.y 14111-1 (MR kGAUMOND Commission No. o
s :+ MY COMMISSION#FF 173907 ey''•• ANN M.GAUMOND
v
EXPIRES:December 7,2018 ;:q = RAV CnMMISSInN it FE 172CIM
F�,•• Bonded Thru Notary Public Underwriters y ` EXPIRES:December 7,2018
a:
Revised 07/15/2014 Bonded Thru Notary Public Underwriters
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