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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:1 � 22r-14 Permit Number:
� RECEIVFp
Building Permit Application pCT29
Planning and Development Services 1019
Building and Code Regulation Division Permittin
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie eQu�ty ent
Phone: (772)462-1553 Fax: (772)462-1578 Commercial I< Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED,IMPROVEMENT LOCATION:
Address: 22 L-Pty-15 ,li�T 'k fM,- Zo 7- l
Legal Description:
\cs,Y'A�- "T- L'VC'IC 'Z'C_Y� 2r urs q ab2
Property Tax ID#: co- O?� - Lot No.
Site Plan Name: Block No.
Project Name: STI
Setbacks Front NIA' Back: 4"/4- Right Side: Left Side:
1,'0 E- TAILED,:bESCRIPT' ION,OF"WORK
CONSTRUCTION INFORMATION ,
Additionalworkto e ,e orme under this permit-check a at pp y:
11HVAC Ei Gas Tank []Gas Piping Shutters a Windows/Doors
1-1 Electric ElPlumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Scl. Ft. of First Floor:
Cost of Construction:$ Utilities: _Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR.:
Name 'rk Name: MICHAEL GOODWIN
Address: Rg- C.�� LA5,1 D„ IOU, ft Company: 3ENSEN BEACH ALUMINUM
City: /L'r S?- rte!c.(r-_1 State:r� Address: 1720 NW FEDERAL HWY
Zip Code: ?L(C rZ, Fax: City: STUART State:FL
Phone No. 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.
SUPPLEMENTALCQNSTRUCTION LIEN LAW IR-FORMATION.:;, .
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: FL,-v?•t✓A A1t10fJ41aAA Name:
Address: S"ggo !?A,qn/A04- 5 9 1/0 Address:
City: T.AZ+_& State: ,G1- City: State:
Zip: 3 3Lo�' 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 thepermit 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 addition ,
accessory structures,swimming pools,fences,w IIs,signs,screen rooms and accessory uses to anoth r no idential use
WARNING TO OWNE :Your fa' r t ecord a Notice of Commencem t ay esul n y paying twice for
improveme to r pro ce of Commencement mus e r c ded n sted on the jobsite
before th irs in ti . I y t d to obtain financing, con It t end r o ttorney before
comme cin or i Notice of Commencemen .
s
Signat re dt Owne/L see/Contractor as Agen for Owner Signature of Contrac icense Holder
STATE OF FLORIDA • ll STATE OF FLORID
COUNTY OFIv COUNTY OF
The ff�rV�qi+ng instru a`s cl o ledged before me Ther�g instru e t � s ackn wledged before me
this`L/Uay of 20(4by this Q day of 20 M by
(g4vO1 (A U V r/1MJl n
(Name of person acknowledge g) (Name of person acknowledging)
4
(Si nafure of otary Public-State ofl lorida) (Signature of eta Public-State of Plorida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification' Produced Type of Identification Produced
Commission No. I 12 (Seal) Commission No. �V2— (Seal)
to of Florida
,I►r Notery Pu is � •Angela Staples
Revised 0711 / � Angela Staples My Commisslon GG 235to2
My commission GG 235102 expires 0710412022
.444Expires 07104/2022 a k
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
CO M P LETE
INITIALS
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