HomeMy WebLinkAboutBuilding Permit Application i
Rut-
ALL
t-ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:9� 1�— 0 Permit Number:
Building Permit Application Ssj S
a
Planning and Development Services o�w
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 7E
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: )U_tl S ►n+01 q-w 21✓fit, �K. �a(
Legal Description: 1X,0i14-J 4✓ /l,iT '�/o( dNA'10�
Property Tax ID#: Oroff f tot( — oo�-'boo 2 Lot No.
Site Plan Name: "10 Block No.
Project Name: A+( 1`5
Setbacks Front PLA- Back: N a Right Side: a Left Side:-�"—
DETAILED'DESCRIPTION OF WORK :;Fm
7 v�J���rvbs �C�o�L Jiq�
CONSTRUCTION INFORMATION
Additional
or to a eunder this p —check
a t t appy:
❑HVAC tasTank Gas Piping Shutters nl Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 1v b s� Utilities:cn Sewer❑Septic Building Height:
OWNER/LESSEE: CONTRACTOR: ;
Name 291LI-1�i i Q'LFf� Name: MICHAEL GOODWIN
Address: 1?�b9 S �n��Y+✓ Xi V94 Oxt fO/ Company: JENSEN BEACH ALUMINUM
City: Tk'Arytry Xa*r. State: B Address: 1720 NW FEDERAL HWY
Zip Code: Jr 7 Fax: City: STUART State:FL
Phone No. '74 2— —7Y�7D 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.
I
i
i I it
SUPPLEMER, L'CONSTRUCTION L'IEN;LAW INFOaRMATION
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Ao4t134UUM AWI &7 b Name:
Address: o 44J d&c16- Jk001 Address:
City: t !c State: City: State:
Zip: Phon Z Zip: Phone:
FEE SIMPLE TITLE HOLD R: _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 no -residential use
WARNING TO OWNER:Your go
re rd a otice of Commence t may result i a ing twice for
improvements to your pro ea of mmencement m t be ec ded a on the jobsite
before the f' t I s ctio . Ifn d to tain financing, c nsult wi ender r rney before
commen ' w r r r or e of Commence nt.
/7 s
Sign atua of wner/Lese/C ntractor as Agent for Ow ig ature of Contrac ices a Holder
STATE OF FLORIDA ° 11 STATE OF FLORIDA
COUNTY OF �}Q�i N COUNTY OF czt1+�
The forgoing instru t w s knowledged before me The for ing instr ent wa cknowledged before me
this�day of z IL 20 ]�by this ��day of �u�bC 20 l�1 by
W L dc,,,c�
(Name of per on a kno edgin ) (Name of r er on <n wledg' g)
1 � l
(Signat a of Nota Public- ate of Florida) (Signatu of Nota Public- ate of Florida)
APersonall nown OR Produced Identificationa Personall ownOR Produced Identifi ation
T e o roduced Type of Identification Produ e
r JOHN LEE TINNEY q p'u's: JOHN LEE TINNEY
Commission No.tJ'l� '6tary('�OWO State of Florida Commission NX /�-� �QI No(ftftl)lic-State of Florida
I: Commission#GG 268344 '-_�' o` Commission#GG 268344
rrt My Camm.Expires Nov 15,2022 oF °o- My Comm.Expires Nov 151,2022
Bonded througn NationalNotary Assn.
Revised 07/15/201
REVIEWS FRONT ZONING SUPERVISOR PLANS 'VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
CO M P LETE
INITIALS
it
II
I
I