HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLI ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0 --L,9) Permit Number: f 0
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Building Permit Application 0
Planning and Development Services Permitting Depart
St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential Y ,
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: IS r.iye.we-A-oil- C,r i PEAT 43. --fic,‘ ( qt, St 4 gY1
Legal Description:
G6})1.6 Co ki‘ -Lmir I fko At 4.0.1- z. (04 Sly-AC.4
Property Tax ID#: mg- 701- wn -eco-6 Lot No.
Site Plan Name: ,..._,, x„vitz,6544 Block No.
Project Name: .D:4"onet9ic)"/
Setbacks Front lvtif-- Back: digh- Right Side: t-1/4- Left Side: All'fr
DETAILED DESCRIPTION OF WORK
;;;' ifkt/44 .4794 -- 7crAwatz,s- 2.-2ric,,-----
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CONSTRUCTION INFORMATION:
Additional work to beiertormed under this permit—check all hat apply:
_
HVAC I 1 Gas Tank Gas Piping Shutters /Windows/Doors
r-Electric El Plumbing Sprinklers Generator Roof Roof pitch
—
Total Sq. Ft of Construction: S9,4 of First Floor:
Cost of Construction:$ 7/ it OCO
Utilities:I _Sewer _Septic Building Height:
OWNER/LESSEE: , CONTRACTOR:
Name 7.2a"e2,0 ) A/47,004/ Name: MICHAEL GOODWIN
Address: /?5 (76/kfri NV M.-774,-- Ct Company: JENSEN BEACH ALUMINUM
City: 17-70/4— Pena State: Fe- Address: 1720 NW FEDERAL HVVY
Zip Code: .3q47 / Fax: City: STUART State:FL
Phone No. 0760 —mi.,9 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 1
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from the Owner listed above) State or County License: CGC 1508437
h-CIV\ 1
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: I
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 I
WARNING TO OWNER:Your failur: to Record a Notice of Commencement may result in • r paying twice for,
improvements to your pr•pe ty/' otice of Commencement must be r- orded a/•o.ted on the jobsite
before the first ins i-ct./ . . ,� intend to obtain financing, consult 'derj% •�: ••rney before
commend � �,efor c ilrif.ur Notice of Commencement. / //
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Signa ire . Owner/Lessee/Contracto - e.- t for Owner'llaWSignat e of Contract•r/Lice e o :-
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Sr LOC4E, COUNTY OF '97- X ot-v
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me `
this4gdayof /1" y , 20/9by this6 ayof,e1/9/ ,20/99 by
/6-i7G, i9 a/� /,d _/(,/CA9,9 -L.... �.GYa //rte
(Name of person acknowledging) (Name of person acknowledging))'
_.- te-'' C t ------i e G �' � -� "� t ..--rfr.f.. f'
(Signature of Notary Public-State of Florida) (Signature • otary Public-State orida)
Personally Known t/ OR Produced Identification Personally Known ...,- OR Produced Identification
Type of Identification Produced Type of Identification Produced r
Commission No. Commission No. • N M GAUMOND
r) •t.;1k, ANN M.GAUMONO '+'= MY COMMISSION#GG 269714
I .•, #GG 269 .1.1 a,. ;,
I . ,1 0224 :7�'!`L•o: we :•:.i'-1' , 1..
ice.
��v o: EXPIRES:December 7t 2 �oF °: Bonded Thru NotaryPubIIC Undef Vers
Revised 07/15/2011 -4Poyq,q: Bonded rim NotayPubGcUndemriteus , . ,
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS