HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I 1� � Permit Number:
RECEIVED
Building Permit Epplicatio JAN a � �,.02;3
I
Planning and Development Services
Building and Code Regulation Division 'ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34952
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT-APPLICATION FOR: To Select from dropbox, ciick arrow at the end of line
PROPtOSED I'IVIPROVEMENT'LOC ATION
Address: I S r i C 5' Da 7,P
Legal Description: —
INoiflyl �co�n- u9r-✓ imio 0a �60 2urZ) �L►J67 JJ._1 7- 7c>S Rr,J t•/wo S�
Property Tax ID#: 0S'0I - 8OK— 'VO Lf - p00 — 9 Lot No.
Site Plan Name: �/ rq-NNETi'� Block No.
Project Name:
Setbacks Front Back: N A Right Side: �t' a Left Side: Nlt�-
DETAILED DESCRIP.TION`OF WORK
CONST.,RUCTION INFORMATION:.,
Additional work to be ,nertormed
d under this permit-check all t1lat pp y:
HVAC Gas Tank DGas Piping L__J Shutters Windows/Doors
❑Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S F�:. of First Floor:
Cost of Construction:$ 7 �0 Utilities:0),Sewer Septic Building Height:
OWNER/LESSEE., :.. CO'`« r FACTOR
Name PC>* toWNCrn Nan"te: MICHAEL GOODWIN
Address: lei r ��/OrdfTl Ri,/e7t- 012- �_70r Col1pany: JENSEN BEACH ALUMINUM
City: SCy &Ae-& State: FS Acl Ess:-1720 NW FEDERAL HWY
Zip Code: '/N 9F-7 Fax: City: STUART _ State:FL
Phone No. I ��1d Imo3 - �) 5 Zip C.crfe: 34994 _ Fax: 692-9744
E-Mail: Phone No. 692-0090
Fill in fee simple Title Holder on next page(if different E4&lil; MICHAELLGOODWIN@YAHOO.COM
from the Owner listed above) Stat: co;County License: CGC 1508437
If value of construction is$2500 or more,a RECORDED Notice of Comrn,�rncement is required.
4
SUPPLEMENTAL CONSTR.UCTI"ON LIEN LAIN IN:
FOR
DESIGNER/ENGINEER: Not Applicable M
ORTGAGE COMPANY: _Not Applicable
Name: E0m1i�n slt,� rne:Address• J �'� �0ess:
City: State: mac. City: _ State:
Zip: 9�� Phone: ?ZZ'7 J Zz?,- �o9 Zip: ____ Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BON01-46 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 reviev,;•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,fen s,walls,signs,screen rooms and accessory uses to another no -residential use
WARNING TO O NER:Y ur failur to or a Notice of Cot im�r_nncernent m result i yo r yi twice for
improvemen o our p perty. N ice f Commencemer.., must be r corded d os d n the jobsite
before the first i specti ,n. I y in d obtain financing, consult th I er or, or ey before
commencing wo r r cor i Ice of Commencemerit.__
Vz s
Signatu of 0 ner/Less Cont actor as Agent for Owner Sigrt? .ire of Co trac License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Mcor_6In COLl!f _11(OF—_ Mn,lr-k�y1
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 7 day of '�J Un 20 Eby this-3.-day of 20 aU by
yy 'C" 40 0 karl4k
(Name of person acknowledging) (N2IT;I-of person acknowledging)
r)l 0,
(Sigrikuke of tary Publi -State of rida) (Signa_a,L of N t ry Public-State of Flo a)
Personally Known OR Produced Identification Persor o;!y Known ✓ OR Produced Identification
Type of Identification Produced TyF;e _7 ;der:tification Produced
Commission No. ? 62— (Seal) Comrni_.sion No. ✓S��L (Seal)
State of Florida -- -_-----.— tai tic St
ate of Fforh i
ip `�``� Angela Staples �? � Angela Staples
Revised 07/15/2014 My Commission GG 235102 ;�,
My Commission GG 235102
5y ' Expires 0710412022 - _ — +� Expires 07/04/2022
REVIEWS FRONT ZONING SUPERVISOR PLA r�! VIEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIE`;N REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS