HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE NFO(/UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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 eind of line
pROPO5ED tIUlPR01lEMENT:LOCATIGIN
Address: 10751 S OCEAN DR LOT A15,JENSEN BEACH FL
Legal Description: 11 37 41 FROM SW OF SEC 12-37-41 RUN 89 DEG 55 MIN 14 SEC AiLG S SEC LI 774.41 FT TO C/L
OT A1A TH N 23 DEG 49 MIN SEC W ALG SD C/L 2921.33 FT TH S66 DEG 10 MIN 29 SEC W 290.01 FT TH 87 DEG
Property Tax ID#: 4511-311-0019-000-2 Lot No.
Site Plan Name: PETERS Block No.
Project Name: PETERS
Setbacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
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DE7AILEt3 DESCRIPTION qF WORK
HURRRICANE SHUTTERS ( PANELS 17 OPENINGS)
CNSTRUCTtON IORIViATION
NF °T
Additional work to be nertormed under this permit—check all appy:
❑HVAC Gas TankElGas Piping - Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers 1:1 Generator E Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 4450.00 Utilities:cn Sewer Septic Building Height:
C+INNER/CESEE. �' ' CUNTRAGI`OR y
Name JAMES L PETERS Name: MICHAEL GOODWk,
Address: 10751 S OCEAN DR LOT A15 Company: JENSEN BEACH ALUMINUM
City: JENSEN BEACH State:FL Address: 1720 NW FEDERAL HWY
Zip Code: 34957 Fax: City: STUART State:FL
Phone No.229-2269 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: , Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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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 I will,in all respects,perform the work
in accordance with the approved plans,the Florida B 'ng Codes and St.Lucie County Amendments.
The following building permit applications are ex from undergoing a full concurrenc eview:l ro m additions,
accessory structures,swimming po Is,fe a al ,signs,screen rooms and accesso es to an er n-residential use
WARNING TO OWNER:Yo fail cord a Notice of Commenceme a s t i our paying twice for
improvemngw:
Rol(
r pr per o Ice of Commencement must r c r e a posted on the jobsite
before theti . If o i t nd to obtain financi u w n er ttorney before
commencir cor u Notice of Co ncement.
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Signature of Owner/Lesse ractor as Agent for Owner ignature of Contract icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF E�n /Q2(_1� COUNTY
The forgoirig instrument was acknowledged before me The forgoing instrument was acknowledged before me
thZy of 20/;:2"by thb;ZP41ray of 201 by
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(Name of person acknowledging) (Name of person acknowledging)
(Signa re of Notary Pu ic-State of Florida) (Signatur!- f-Notary Public-State of FFoda)
Personally Known OR Produced Identification Personally Known OR(Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. $e
.�4�1'`•?Ye y,
ANOWAIROION 4 PF 173
M.GAUMOND ;=QtiY•`y�;�'.,, rANN M.GAUMOND
kAV* EXPIRES:December 7,20t3v18mycommToRwi-it -C.. a EXPIRES:December 7,2018
Revised 07/15/201 '; �F�4h;< Burs=: :Dery Public Underwriters RF Bonded Thru Notary Public Underv+rders
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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