HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONJ
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ALL APPLICABLE INFO MUST BE COMPI.ETED FOR APPLICATION TO BE ACCEPTED
Date: I a� 1 Permit Number:,
C 2 0i ` AW.,
Building Permit Applicatilt�n
DEC 2 1 2017
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 BY: .......................
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial . Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
l?ROPJSED IIVIPROVEMEIVT LU10N
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Address: 9 LAKE VISTA TRL 207
Legal Description: VISTA ST LUCIE BLDG 9 UNIT 207 (OR 2393-25320
Property Tax ID #: 3422-500-0126-000-9- Lot No.
Site Plan Name: MODICA Block No.
Project Name: MODICA
Setbacks Front NIA Back: NIA Right Side: NIA Left Side: NIA
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DETAiLEC7,DESCRIPTION OF V1►"uI,Ky' n4 YJ
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kt n.5•iR .^E+.y' t.Yj,' .Y' `' w+'L+ '; Y, ?fEF°.. "'E. .
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ENWALLS WITH GUARDRAILS /iNFILLS �y,MPyH EXP 13/EXISITING CONCRETE SLAB
SCRE41
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CONSTf2U,CTI0N INEURMAT! ONI
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iAddwtmonal work tobe neorm�ed under t his permit — check all apply:
�FVAC Gas Tank I]GasPiping —_Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Ro6f pitch
Total Sq. Ft of Construction: �_ _ I S . Ft. of First Floor:, .
-Septic
Cost of Construction: $ 2000.00 Utilities: _ Sewer Building Height:
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Name MODICA, JOHN Name: MICHAEL G(.,ODWIN
_
Address: 4 OAKDALE CT, Company: JENSEP i BEACH ALUMINUM
City: RIDGE _State: NY Address: 1720 NW =EDERAL HWY
Zip Code: 11961 Fax: City: STUART State: FL
_
2841-4229 "- 34994 692-9744
Phone No. _ � � Zip Code: _ Fax:
J
E-Mail: - Phone No. 692-0090
Fill in fee simple Title Holder on next if different E-Mail: MICHAELU;�OODWIN@YAHOO.COM
from the Owner listed above) State or County L<<;,'`nse: CGC 1508437
If value of construction is $2500 or more;` a; RECORDED Notice of Commencement is req-.ired.
;SUPPLEMENTAL CONSTRU 7110 _N'LA1N`INFO;RMATION: ")
DESIGNER/ENGINEER: _Not: Applicable MORTGAGE COMPANY: _ Not Applicable
Name: A+FGUIDE L Name:
Address: Address:
City: ` State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
Citv:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: — Phone:
Not Applicable
I certify,that no work or installation has commdnced prior to the issuance of a permit.
St.Lucie-Count makes no representation.that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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 requ" sted permit, I do hereby agree that I will, in all.respects, perform the work
in accordance with the approved plans, tle;Elorida 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 non-residential use
WARNING TO OWNER: Your failur Record a Notice of Commencement may result in your paying twice for
improvements to your pro WIftrerid
once of.Commencemen osted on the jobsite
before t ' st ins ectio . to obtain fina g, consult Ilend n orne before
comm cin wo or r ohl:otice of Comme ement.
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Signature f Owner/Lessee] ractor as Agent,for Owner Signature of Contract r/License Holder 3,
STATE OF FLORIDA'"`
COUNTY OF._((jT Z (] f
The for o��in instrument was acknowledged before me
this/ k7dayof ;,_,('— 201Yby
(Name bf person acknowledging) ;=
(Signature of Notary Pub Ic- State of Florida
Personally Known _�ZOR Produced Identification
Type of Identification Produced
STATE OF FLORIDA
COUNTY OF 9
The forgo instrument was acknowledged before me
this/ day of20%Z by
(Name of person acknowledging )
(Signature NotaryP;ubIic- te-of F or3a )
Personally Known C/ OR Produced Identification
Type of Identification Produced
Commission No. _.�"'%'' ,GAUMOND Commission No.
`Y MY COMMISSION # FF 173907
ANN M. GAUMOND
Bonded Thru Notary Pubic Underwrters 's?�� EXPIRES: December 7, 2018
Revised 07/15/2014 .....
f;Bonded Thru Notary Public Underwriters
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