HomeMy WebLinkAboutBuilding Permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
•
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: _ Z'1-?j N6T _E5 1S L40 TWSpv '(?EAcj4
Legal Description:
�ET-1L6 Kut ,Nc a cvr�o roN i( p,�-►2��� 22s �+'�- '
Property Tax ID#: YI�02- $V I 0 0' —0'7u- Lot No.
Site Plan Name: FY N I_ Block No.
Project Name: '6t24ti�-
Setbacks Front I- A- Back: l� _ Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
0
[CONSTRUCTION INFORMATION:
Additional work to be nerformed under this permit-check a appy:
HVAC Gas Tank []Gas Piping 0 Shutters Windows/Doors
11 Electric ❑ Plumbing Sprinklers 1:1Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ ?ACS .Oo Utilities:cn Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name '130,1/vv- , Name: MICHAEL GOODWIN
Address: Z25 i'Jt,'-7,,s -740 Company: JENSEN BEACH ALUMINUM
City: 717e,�O, --1?C6t - State: , Address: 1720 NW FEDERAL HWY
Zip Code: •TJ S::7 Fax: City: STUART State:FL
Phone No. 1376 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:
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 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 are 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:Your ure to Record a Notice of Commencement ma r s t in your paying twice for
improvements to your p op y. A Notice of Commencement mu re r e and posted on the jobsite
before the first ins c • n/ you intend to obtain financing, co ul it er or an attorney before
comm In or r e in our Notice of Commenceme t.
i
s
Signat re of Owner/Lessa/Contractor as Agent for Owner Signature of Contracto icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF a2— I_JGI COUNTY OF ':S,7—
The
jThe forgging instrument was acknowledged before me The forgoing instrument was acknowledged before me
thi ay of ,�)!Z!/ 20j�by this— y of /�U!/ 201 by
(Name of person acknowledging) , (Name of person acknowledging)
(Signature of Notary Pub l -State of Florida ) (Signatuk-ct -Notary Public-State o -Florida)
Personally Known i,,," OR Produced Identification Personally Knowr>L�OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. GAUMOND Commission No. (Seal)
:.: MY COMMISSION#FF 173907 t -
' - FYPIPPS.DPcnnhPr 7 2019 ANN M.GAUMOND
"'>4' Bonded Thnr Notary Public Underwrters :;,. MY COMMISSION#FF 173907
Revised 07/15/2014 -!' u'
•-i; EXPIRES:Oecer7ber7,2018
Bonded Thru Notary Nublic Unaerwriters
3
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
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