HomeMy WebLinkAboutGoodhue.ac.permitAll APPLICABLE
INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I t Zi Permit Number:
I J 1
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 f
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential V
PERMIT TYPE: A-L cta4t,,-,e- cc- - L.; ,e -66r L lLec
PROPOSED IMPROVEMENT LOCATION:
Address: T al l Z 5&E � �j (a_T
Property Tax ID #: 34 2-14 - 701- 00�-p% _ C-00 -2 - Lot No.
Site Plan Name: FA-X�_7LC5 IZ-OFa WT Al- 'VA`VA�� <fC-U,6 Block No. L%
Project Name:
DETAILED DESCRIPTION OF WORK:
1
CONSTRUCTION INFORMATION
14
Additional work to be performed under this permit- check all that apply:
/lechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ �3ik,'50
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name o{je--+ ooE i kL)e,
Name: f\11011'+0
Address: Jq (Q IB W L l_i c t Dr
Company: _T�' / t'5 `t-h(. 'Plam %r `-AIC-C
City: FFof--+- et- Lv" c-- State: T::t-
Zi Code: el-( �1�Z Fax:
P
Phone No. _Z4V - CS- 17-7 `Z.
Address: I ;_;� 'SF
�—
City:F"—(- S;. (..� "e- State: L_
Zip Code: 349 �- Fax:
Phone No 77.2--337-32.-2--2-
E-Mail /'Yla i f-7,4
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License i / 3% -77%(4
11 VCIuC V I wnMLI ucuun is ,vwcaw or more, a KtLUKUtu Notice or commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
vt=a1u1'VCK/ItiVt��NrER: — Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLEHOLDER: Not Applicable
Name:
Address:
City:
ZIP: Phone:
MORTGAGE COMPANY: Not Applicable
Name: —
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone
_Not Applicable
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
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, wails, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you i tend to obtain financing, consult
wit lee r or an attorney bef a commence work or recordin our N ice f Com cement.
Sig ature of Owner/ Lessee ntractor as Agent for Owner Signatu of Contra or/License H I r
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF J-r Ljc4 ic, COUNTY OF W,
Swpn to (or affirmed) and subscribed before me of
ysical Pre ce or Online Notarization
this day of 202# by
Name of person making statement. /
Personally Known V OR Produced Identification
Type of Identification
Produced
of Notary
Commission No.
REVIEWS I FRONT .
COUNTER
DATE
RECEIVED
DATE
COMPLET
OiANE MLE
Notare of Florida
COMMM >t GG 961089
My Comm. Expires Mar 14, 2024
Sworn to (or affirmed) and subscribed before me of
/ Physical Presence or Online Notarization
this 14 day of 202# by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Prodpced
Signature of Notary Public- State of F DUNG COL
^` Notary Public - Stat,
Commission No.
` Commission N GG
MY COMM. Expires M
Bonded though National i
ZONING SUPERVISOR I PLANS I VEGETATION I SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW I REVIEW REVIEW I REVIEW
2024
Assn,