HomeMy WebLinkAboutAPPLICATION-103EDENCREEKLNAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Rate: Permit Number:
LI LUFC Ir .
iy L
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:window replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 103 EDEN CREEK LN ,JENSEN BEACH
Property Tax I D #: 4509-807-0006-00013
Site Plan Name: MAY
Project Name: MAY
Residential X
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: I
WINDOW REPLACEMENT 3 OPENINGS IMPACT
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit —check all that apply:
Mechanical Gas Tank —Gas Piping Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator T Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 6300.00 Utilities: —Sewer —Septic
Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
NameJONATHAN MAY
Name:MICHAEL GOODWIN
Address:103 EDEN CREEK LN
Company: MLG CONTRACTING LLC
City. JENSEN BEACH State: _
Zip Code: 34957 Fax:
Phone No. 954-931-0319
Address:1450 SE GRAP ELAN D AVE
City: PORT ST LUCIE State: FL
Zip Code: 34952 Fax:
Phone No 772-418-0560
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail MLGLLC@PROTONMAIL.COM
State or County License CGC1 527586
if value of construction is 2500 or more, a RECORDED Notice of Commencement is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated_
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
bylaws that may restrict or such
which is in conflict with any applicable Home Owners Association rules, or and covenants prohibit
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 addi ions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another n -residential use
WARNING TO OWNER: Your it a Record a Notice of Commenceme may resu in ing twice for
improvements toy r o A Notice of Commencement st a co a the public records of St.
Lucie C ty a d st a t jobsite before the first inspe ion. I u i en o obtain financing, consult
with nde o a tt ne re commencing work or re rdingy r N tic f Commencement.
Sig ature of wner/ L see 1tractor as Agent for Own
ig to Contra or se Holder
STATE OF FLORIDA
STATE OF FLORID
COUNTY OF
COUNTY C _ -�-
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Js
this day of 2020 by
Sworn to (or affirmed) and subscribed before me of
d P��h,ysical Presence or Online Notarization
thi oZS'`day of 2020 by
Name of person making statement.
Name of person makingstatement.
Personally Known OR Produced identification
Type of Identification
Produced
Personally Known V OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida }
(Signature of No ary Public- State of Florida
Commission No. (Seal)
Commission No_ 4 �+ ?''. 5A Flo id0fr Public
*= Commission M GG 192960
My Commission Ex ires
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REVIEW
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REVIEW
DATE
RECEIVED
DATE
COMPLETED
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