HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ro
i Date: Permit Number:
i
Building Permit Application �� ': .
Planning and Development Services va
Building and Code Regulation Division Co4'��j
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 IIVIRROVEM'E'N.T, LOCATION:` `
Address: 73eu S' O 2n #//7
Legal Description: Putii9vAlk k"-/ 777-/ QC-&Z �
6 L�� Uwl T //7
Property Tax ID#: l0fl 7- eblo j - 600- Z Lot No.
;Site Plan Name: Block No.
Project Name: dw?, ,
'Setbacks Front Back: Right Side: Left Side:�La
DETAILED DESCRIPTIO(V'OF-WORK
tS iiNd Co��un s4ov e eccoz-
C NSTRUCT',,ION INFORMATION -a
Additional workb
to_. �. _del _
e e orme under this permit-check a that app y:
HVAC El Gas Tank ❑Gas Piping Shutterswindows/Doors
0 Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
'Total Sq. Ft of Construction:. S . Ft.of First Floor:
.Cost of Construction:$ �4 , 2S?J UtilitiesInSewer 0Septic Building Height:
OWNER/LESSEE ,f CONTRACTOR:
f. ;..d..A. .y ..
!Name A10/VZAIL Z 1, G/7-6- r- Name: MICHAEL GOODWIN
Address:v &:Q /l(W A01-1 Company: JENSEN BEACH ALUMINUM
City: Q1,An-TA77 State: Address: 1720 NW FEDERAL HWY
Zip Code: ?r?J 3 2 Fax: City: STUART
State:FL '
Phone No. tl/119-f, 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.
SU,PP.LEMENULyCONSTRUCTION°LI ER;LAW,I NEP RIVIATIO;N „•
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Ptopwi7o, fJt4A111LmjnName:
Address: 7 Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone:' Zip: Phone:
II 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
�n 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 anot r on-residential use
WARNING TO OWNER:YV
u Record a Notice of Commenc nt may r ul t .your paying twice for
improvements to your pr otice of Commencement st a reca a posted on the jobsite
before the firs inspecti tend to obtain financing, c ns t it d r an attorney before
comm ci ork r rur Notice of Commencem nt.
— S
Signature of Own er/Lesse tractor as Agent for Owner -signature of Co tractor se Holder
!STATE OF FLORIDA STATE OF FLORID -
1COUNTY OF /��(��LyL COUNTY OF �7�t•
I '
The forgoing instru nt was ip'cknow edoed before me The forgoing instrument was acknowledged before me
this day of 0 Eby this day of 1Ab!!K 20 IQ by
((Name of person acknowledging) (Name of person acknowledging)
(Sign Jtu4 of tary Public-State of Flo ida) (Sign ur of tary Public-State of lorida)
!Personally Known OR!Produced Identification Personally Known OR Produced Identification
iType of Identification Produced Type of Identificati n Produced
Commission No.(S_67,3610f Co ission No. 6Yr?,35j02
Notary Public State of Flo a NA,
'Angela Staples Notary Public State of Florida
el Staples
p:�p;•tef Q/1gq•)'i21 ' MyCommleaion GG
I Revised 07/15/20140' � Expire;0710412022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
;DATE i
;COMPLETE i
INITIALS
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