HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MIDST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ' � ` l Permit Number: '
RECEIVED
�t dlding Permit Application AUG 3 0 2017
Planning and Development Services
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County,FL
Phone: (772)462-1553 Fax: (772)462=1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
RItOPOSED,)IUIPRO';/EMEN'TkL0CATIO.N`
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)
Property Tax ID#: 3402-604-0027-000-2 y 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 DESCRIPTiONOF WORD
WINDOW REPLACEMENT ( 2 OPENINGS IMPACT)
CONSTRUCT(OPJ INFORMATION ^^ x
Additional worK to be ertormed un er t is permit–c ec a I appy:
❑HVAC Gas Tank ❑Gas Piping Shutters Windows/Doors
Electric Plumbing
Sprinklers Sprinklers El Generator Roof Roof pitch
,.
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 2400.00 Utilities:0—Sewer Septic Building Height:
0 6""
Name DAVIS,GLEN&JUDY Name: MICHAEL GOODWIN
Address: 112 E EASY STCompany: 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
t
E-Mail: -0090Phone No. 692
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;RgORDED Notice of Commencement is required.
i'
SUPPLEMENTAL C�NSTRUCTIQIV�LIEN LAIN INF�QRMATION� `� ��� �,;� �� ; � � � � � 3
.., s�' � .�:�M.. °`' ;•- £,SEK `r, 7�: '� °'.��. z?,a, r,, a�;�,.,ti?.., ��rc� ,�`� -.�,; r s .. .n ty;. .,,��. a x.c..
DESIGNER/ENGINEER: _Not<Applicable MORTGAGE COMPANY: _Not Applicable
Name: N/A Name:
Address: Address:
City: i 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 the permit holder to build the subject structure
which is in conflict with any applicable Home:O.wners 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 regUested 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._r mpt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fe es; alis,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Yo f " ure Record a Notice of Commencement may result in r paying twice for
improve me to your p . p ty. otice of Commencement must be recorde :or
ted on the jobsite
before t it spe n y tend to obtain financing, con it e torney before
comm cin r r ec d' our'Notice of Commenceme
s
Signatu4 of Owner/Less I#YGoauaqtor as Agent for Owner S' n re of Contractor/• e se Holder
STATE OF FLORIDA '" '` STATE OF FLORIDA
COUNTY OF 97— I)CIF�` COUNTY OF f?7 .UC,
=er
The forg�oo►►����instrument was acknowledged before me The forgoin in was acknowledged before me
th 9 y of%fJ(�JST 20/Zby tl _�'> of j?L r I ST.20/ by
(Name of person acknowledging) (Name of person acknowledging)
(Signatur Notary Public-State of Florida;),;; (Signatur Notary Public tate of Florida)
J.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. M,GAUMOND Commission No. Seal
tom•.
' yv ro14MISSION#FF 173907 :=o<e Y?ys4c; ANN M.GAUMOND
;ppg
titatary Public UnderwAters EXPIRES:December 7,2018
Revised 07/15/2014 °"'
:nom
,,;�„�;;,;;=;. :• �f�F� Bonded?hm Notary Public Underxriters
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS -.��r•�