HomeMy WebLinkAboutBuilding Permit Application 11
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ty + J
Date: 'ALJ I� Permit Number: Q O luQ wrI/�
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® _ �' RECEIVE®-
ggilding Permit Application
Planning and Development Services AUG 3 0 2017
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue,Fort Pierce FL 34982St. Lucie County, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: S drop
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PROPOSED IIV�PRQUEMEIIIT LOCATIO-h! '.,Fx `4 y k
Address: 112 E EASY ST, FORT PIERCE
Legal Description: INDIAN RIVER ESTATES-.UNIT 03-BLK 15 LOT 1 (MAP 34/10S)9.050AC)(OR 1433-200)
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Property Tax ID#: 3402-604-0027-000-2 Lot No.
Site Plan Name: DAVIS Block No.
Project Name: DAVIS _;;
Setbacks Front N/A Back: N/A.°=: Right Side: N/A Left Side: N/A
DETAILED DESCRIP ION 01=WG� lC t
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HURRICANE SHUTTERS ( 9 OPENINGS ACCORDIANS)
CONSTRUCTIQN INFORMATION r
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itiona war to e e Orme un er t is permit—c ec a appy:
❑HVAC Ei Gas Tank ?]Gas Piping �_Shutters ❑Windows/Doors
❑Electric ❑PlumbingSprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: :'..J Sq. Ft.of First Floor:
Cost of Construction:$ 9000.00 Utilities:Sewer❑Septic Building Height:
OWNER/LESSEE z `° CONTRA1"QR
Name DAVIS,GLEN&JUDYName: MICHAEL GOODWIN
Address:112 E EASY ST Company: JENSEN BEACH ALUMINUM
City: FORT PIERCE __ State:FL Address: 1720 NW FEDERAL HWY
Zip Code: 34982 Fax: City:.STUART State:FL
Phone No.224-0236 Zip Code: 34994 Fax: 692-9744
E-Mail:
I. Phone No. 692-0090
Fill in fee simple Title Holder on next p4g (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 F.ECORDED Notice of Commencement is required.
SUPPLEMENTAL CONST RUCTICJNLIEN LAW INFQRMATION t ti
DESIGNER/ENGINEER: Not"Applicable MORTGAGE COMPANY: _Not Applicable
Name: NIA _ 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: °.S City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has con M—einced 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 Building Codes and St.Lucie County Amendments.
The following building permit applications areexempt 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 failure to Record a Notice of Commencement may result in yo r aying twice for
improvements to your property. A IWice of Commencement must be recorded and ted on the jobsite
before the first inspection, i en� to obtain financing, cons It with n r attorney before
commenci wo o re 'r r �.otice of Com menceme
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Signature of Owner/Less tractor as Agerit for Ow er Signature of C a or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFT /2 :, COUNTY OF 45
The forgoi Instrument was acknowledged'before me The forgoing instrument was acknowledged before me
t of � S7- 24/
_!�rby thaVof _&t) T ,201 by
(Name of person acknowledging) ::''i. (Name of person acknowledging)
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(Sign atur f Notary Pu ic-State of Florida j; (Sign atu re"&14otary Public-State of Florida)
Personally Known ✓OR Produced Identification Personally Known &,-"- OR Produced Identification
Type of Identification Produced Type of Identification Produced
nd
Commission No. ,,� 9P•,
CommissioA7115/201
� =-��"'�-`"� � AN � MOND
Q;�Y°veers ANN M:.GAUMOrNi; ¢ MY COMMISSION#FF 173907
s+ MY COMMISSION#FF/1W907. a., :a€ EXPIRES:Dece
a: epem er tS %S pF y Bonded Thru t\ofary Public Underwriters
Bonded Thru Public Underwriters
Revised
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REVIEWS FRONT ZONING'-";.'_','; SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW` ';:: REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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