HomeMy WebLinkAboutBuilding Permit ApplicationALL 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
RECENED
NOV .,2 6 2019
Permltting Department
_q@; 6N@I@ @@Ynf V
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
FkOP.OSED IM-,oROVE MENT LOCATION: �,. `
Address: / d -Z-DP2 41- S"u f--
Legal Description:
a-r'1 Spa r r r.�f A—o Pz. 09 f V-,O�
�N GoMMB^� "7.t��fi
(Property Tax ID #: sl i s r• OCy3 0 cc Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front /V 9 Back: P- Right Side: ti Left Side:
DETAILED DESCRIPTION OF VIIORK
t�,
CONSTRUCTION-,INFQRMA'tION-'-
Additional work to e 1 e orme under this permit — Check a that apply:
E1HVAC Ei Gas Tank Gas Piping Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator _ Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ �7S"c�0 Utilities:Sewer OSeptic Building Height:
OUVNER/LESS
CONTRACTOR"
Name a'tyvkr.V) 13(A�G{�_
Name: MICHAEL GOODWIN
Address: 1119. Sw t6oTff-
Company: JENSEN BEACH ALUMINUM
City: goN►Zc sG State: 'ram
Zip Code: 3 3 i 26 Fax:
Phone No. / 3��/- a 2.3s
Address: 1720 NW FEDERAL HWY
City: STUART State: FL
Zip Code: 34994 Fax: 692-9744
Phone No. 692-0090
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: MICHAELLGOODWIN@YAHOO.COM
State or County License: CGC 1508437
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTALCNSTRU.CTION LIoEN,LAW INFORMATION,,.
DESIGNER/ENGINEER: _ Not Applicable
Name: 606-JAIVO G 2,;6L6r
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: ta&r (06 -r4 caAAr
Address:
City: Stater
Zip: ; 2R (, y Phone: z -2 ?.a2 — s
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY:
Name:
Not Applicable
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 failure o Record a Notice of Commencement may result in yo gaiying twice for
improvements to your property. ice Commencement must be r rded an p s �d on the jobsite
'before the f' 'nspectio . If o d obtain financing, consult It der torney before
commen ' w rk r re or n N ice of Commencement.
s
Signature oYOwner/LessecrContractor as Agent for Owner ignature of Contract ]license Holder
STATE OF FLOR STATE OF FLORIDA, I�
COUNTY OF COUNTY OF �/i
ThVoZoing instr n t o act n' aefore me
thiday of C 20 y
ame of person acknowledging)
(5gndturodP Nota7OR
Pub[[Statebf Florida )
Personally KnownProduced Identification
Type of Identification Produced
Commission No.
or
Revised 07/15/2014
The forgo: g instru ant was ackno ledge before me
this �ay of 20 by
W r��(d 76 wL&�
(Name of person acknowledging)
(Signature oWotary Pu ' - State oVIorida )
Personally Known OR Produced Identification
Type of Identification Produced
bI-c State of Florida OmmIS510n No. l� DZydptary dW�Rtete of Florida
Angela taples ,p Angela', St es
i My Commission GG 235102 f,�y Commission GG 235102
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