HomeMy WebLinkAboutBuilding Permit Application 1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I p I 210 Permit Number: add )i a 0�
I,. RECEIVED
Building Permit Application JAN 0. 8 2020
Planning and Development Services
Building and Code Regulation Division ST. Lucie County,Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
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: c6Aej Pn 313
Legal Description:
�uiv�•�� �y �� 6�M1 A K� s�.o hoc-�sh2 No�nf- ��' � uN,f 3�
Property Tax ID#: 3 5_ bol —0065" C '� Lot No.
Site Plan Name: ic.c-t Block No.
Project Name: d:_1'(
Setbacks Front N A' Back: 1'1A Right Side: !" A- Left Side: H o-
DETAILED DESCRIPTIONOF WORK., .",.,
All
IV
-7
CONSTRUCTION INFORMATION:
Additional work toe performed under this permit-check a that appy:
HVAC E] Gas Tank []Gas Piping Shutters Inj Windows/Doors
Electric ❑ Plumbing Sprinklers I Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ /c�T �,ao Utilities: _Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name •ual .44_Z00 Name: MICHAEL GOODWIN
Address:--/ Z 04wo.r1 L—N Company: JENSEN BEACH ALUMINUM
City: rys% Ss -Lc -.v6 4 State:� Address: 1720 NW FEDERAL HWY
Zip Code: 11T4 13 Fax: City: STUART State: FLS
Phone No. (o, ! J (og�/- S'9J�� 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.
1
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: COwAW-o Name:
Address: U26t- (ooT-;- C o,_Pf' Address:
City: Vag Stater City: State:
Zip: 2,2 1/„:J Phone: Zti 2 %o'B 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 additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another no -residential use
WARNING TO OWNER:Your it e e d a Notice of Commencement may result in r paying twice for
improvements to your pro rt . t' of Commencement must be recor d a osted on the jobsite
before the fir ' spectio 11If 1 e to obtain financing, consult I d r r ttorney before
commenci wok re rd' otice of Commencement.
s
Signatur6.of Owner/Less ontractor as Agent for Owner Signa re of Contractor/Lic se Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF I/1 COUNTY OF_ MCtl(-V4
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of _3Un, 20by this day of I—C,yJ 20 dU by
60
(Name of'person acknowledging) (Name of person acknowledging)
(Signatur6 of No ry Publis-State of FloridV) (Signature of N&Iiry Public-tate of Plorida)
Personally Known ,, OR Produced Identification Personally Known -/ OR Produced Identification
Type of Identification
-Produced Type of Identification Produced
Commission No. C Notarg�e�k State of Florida Commission No. [.�5 N a a� ,ic State otflorida
Angela Staples o `wo � Angela staples
myCommission GG 235102
Commission GG 235102
MV Expires Expires
Revised 07/15/2014 �~ ��`�
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS