HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAB E INFO BE COMPL.Ti D FOR APPLICATION TO BE ACCEPT[.D 1
Date: ) Permit Number: / ' t7 4
tu11ding Permit Application
Planning and Development Services
MAR �01�
Building and Code Regulation Division 14
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Tod`►Fiect from dropbox, click arrow 2:the end of line
PROP�v. t
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,SED IMPROVEMENT„L�( fi110N
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Description:(J [ F� ISL.pNyr? I NG_� Cyn�hO S t-T► + I P�/L�L V-7
Property Tax ID#:— bZ - :� .- 0000 - Olw -5' Lot No. VIA
Site Plan Name:� 400 Block No.
Project Name: __..
Setbacks Front Right Side: �/ P- Left Side P►'
DTAIL`'ED DESCRIPTION C?E`W3T.
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w l N►�Ow,= �� I N CSI O�'� - bLI A10911v1
CC}NSTRUCT O
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itic:na worK toe pert(-;rme�ndee is permit-check a appy.F
HVAC Lj Gas Tank ::: ]Gas Piping —ShuttersWindows/Doors
Electric E-1 Plumbing ;-= C]Sprinklers Generator Roof Roo”pitch
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Total Sq. Ft of Construction:` ;t''a Sq. Ft. of First Floor:
Cost of Construction:$ 6b0 Utilities:El Sewer Elsa•jtic Building Height:
QWr,. NER/ ESSEE
ONT
Name__ n( � _;:. Nanne: MICHAEL GG,-QWIN
Address: 35 NS- /DOT�� S I Company: JENSEN BEACH ALUMINUM
Cit 1720 NV! r DERAL HWY
City:_�1M/Q State:M / Address: _
Zip Code: �/CJ/�f'o cI,,/� Fax:_ City: STUART State:FL
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Phone iVo. / �i1 2 Zip Code: 34994 _ Fax: 692-9744
E-Mail:_ - _ Phone No. 692-0090
�OODWINYAHOO.COM
Fill in fee simple Title Holder on neMICHAELL.xt°I�a•�;e.(if different E-Mail: aG�
from the Owner listed above) State or County Lir-nse: CGC 1508437
If value.of construction is$2500 or m&'e a REC0RDED Notice of Commencement is reiv Fred.
SUPPLMENT`Ai.CQ�NSTRUGtQ'Ni~IEN�LAUONT,Q�RM/�TIC}N�
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: 11''�� Address:
City: -_State: City: State:
Zip: Phone:_ _ Zip: Phone:
FEE SIMPLE TITLE HOLDER: _:Nbf Applicable BONDING COMPANY: Not Applicable
Name: - Name: _
Address: Address:
City: City:
Zip: 'Phone: Zip: Phone:
I certify that no work or installation h4s'6 p fii-enced prior to the issuance of a permit.
P.St.Lucie County makes no representation That is granting a permit will authorize theperr-iit 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 O'wiiers Association and review your deed for'a?i(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,theiFlo ida Building Codes and St.Lucie County Amendments.
The following building permit applications,-`ard 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:Yo/e .
ec
ord a Notice of Commencement may resuI i paying twice for
improvements to your proof Commencement must be recorded ste on the jobsite
before,the ' s 'ns cti o obtain financing, consult h . n a rney before
comme n w or coce of Commencement.
Signature of Owner/Less a Can tractor,as Agent-for Owner Signature of Contractoyr/Li ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ,—'G7— L r>C1 COUNTY OF _!97!-1f'
The fo �instrument was acknowledged' efore me The forgoing instrument was acknowledged before me
thi-b of 201 y thja�o� ay of � 'C_��201�by
404-0)
(Name,of person acknowledging) .<<;z_;,i (Name of person acknowledging)
(Signatu f Notary Public-State o . QfiKI)i;.; (Signature -Notary Public-ttate of Florida)
Personally Known✓ OR Produced Ide;:tification Personally Known r/ —OR Produced Identification
Type of.Identification Produced _ Type of Identification i�roduced
Commission No. „ Commission No. _ (Seal)
MPia-,, �1NN.M:GAUMOND
, .
'rR PC'-.6k p`pPY P e,, ANN M.GAUMOND
*` 14 EXPIRES;DeceL�b
MY COMMISSION#FF 173907.
Revised 07)15/201 %Fp4 Bonded 7hcd Notary - EXPIRES:December 7,2018
Bonded Thru Notary Public Underwriters
— N.ta m
REVIEWS FRONT ZONING',. SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW = i REVIEW REVIEW REVIEW REVIEW REVIEW
DATE i
COMPLETE
INITIALS