HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE EEIaaNFO(MUUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED C`�
Date: ��iu� I I Permit Number: 1 I I— o 5YO
RECEIVED
Building Permit Application NOVX.6 zoos
Planning and Development Services
Building and Code Regulation Division Permltting Department
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucle County
Phone: (772)462-1553 Fax: (772)462-1578 Commercial ' Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
P,,ROPOSED IMPROVEMENT LOCATION:..
Address:
p i S Z 5 o 4xij DIt, St•9
Legal Description: A-f LAMS Cow 0 '(3 C-DI- X U/"' r St
Pilo /1-"-A C b5g14e- //^ c v tmepr a`1
Property Tax ID#: L(rb2- 013"i2 Lot No.
Site Plan Name: CA"VA'r'` Block No.
Project Name: CA'`raz�to
Setbacks Front t' p' Back: tip Right Side: Left Side: N1A
DETAILED DESCRIPTIONOF WORK , , 7 `'
CON '.:
STRUCTION, INFORMATION
Additional work to e nerformed under this permit-ZhecFa-11 that apply:
OHVAC Gas Tank Gas Piping ❑Shutters L_-'1W.indows/Doors
0 Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:�" S Ft. of First Floor:
Cost of Construction:$ t�/(/JoC7 Utilities..
Septic Building Height:
OWNER/LESSEE:, . CONTRACTOR:
Name 11/1k/9 Name: MICHAEL GOODWIN
Address:: /r'( L&A---, /)4 Company: JENSEN BEACH ALUMINUM
City: 1 Sf '?L State: Address: 1720 NW FEDERAL HWY
Zip Code: �c4gr'-7 Fax: City: STUART State:FL
Phone No. 4%0) ,� Zip Code: 34994 Fax: 692-9744
E-Mail: —k, 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 CON STR°UCTION,LIEN LAW INF.ORMATIONp
.F
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Wtyft 0 e Qas i 7 Name:
Address: �Z65-: &,Tt� Zo,4 .1,r Address:
City: ven. �� �f State: F�- City: State:
Zip: 2967 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 fail r to Record a Notice of Commencement may result in y ur paying twice for
improvements to your prop rt . Notice of Commencement must be forded d sted on the jobsite
before the fir 'nsp ctio . I y ntend to obtain financing, consult it I nder or attorney before
commenci work r re or i our Notice of Commencement.
s
Signature of Owner/L ee/Contractor as Agent for Owner Signature ontractor L ense Holder
STATE OF FLOR,�D STATE OF FLORID���COUNTY OF 1 aAll& COUNTY OF
Thekoin instrum tnwas acl ?owledged yre me The forgoin Yinstru ent was cknow edged bbef�e me
thisdayof ���Y].Q 7.(�� this da of 20 b
pkyj k)t�
(Name of person acknowledging) (Name of person acknowledg g)
(Si n ture Notary Public-State cq Florida) (Sight lure of&tary Public-State of Flor da)
Personally Known OR Produced Identification nally Known OR Produced Identification
Type of Identification roduced r; aTy of Identification Produced
�� Notary Fu 18 les
Bela S p 2351 2 ublic Slate of Florida
Commission No, ary
Commission GG Co fission No. )Staples
Expires 07M412022 My Commission GG 235102
a w Expires 07/04/2022
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS