HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
ALL APPLICABLE INFO MUST BE COMPLL ED FOR APPLICATION TO BE ACCEPTED
Date: � I Permit Number:
I
S@A�falED
RECEIVED
B�ai �i�ugC - a it Application FEB 2 3 2018
Planning and Development Services ST. Luc county, Building and Code Regulation Division y, Pmrmitting
2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462.1578 Commercial Residential X
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PERMIT APPLICATION FOR:
To Select from dropbox, click arrow at the end of line lOm C ci f Pori
.PROPOSED"IMPROVEMENT LQ k''liTION ,°,` I
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Address: 35Lf SEIA'f�ds�� T ?.i2, T 0�✓Le /ter✓
Legal Description: O ��?e�� 6aZYLII on-C --�
Property Tax ID#: O- S`b8_- CCKO -3 _• Lot No.
Site Plan Name: N4J aL toVkz-)-� I _ Block No.
Project Name: M J CC- 1 O,,_-b I r
Setbacks Front Z 1"' Back:`_.._. Right Sidle: Left Side:
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DETAILED DESCRIPTION OF W.6 ' 7 °
cq G ✓`Gvrf �So�--r-✓vdS,
A0a,0VP44�
CONS;TRU'CTION INFORMATIO(V4i,
Additio work to e e orme under nis permit - check a apply:
11HVAC fi Gas Tank j]Gas Piping _ Shutters O Windows/Doors
❑ Electric ElPlumbing =- OSprinklers E Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ /O o Utilities:Sewer Elseatic Building Height:
OWNER/LESSEE: .� -- .... .
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NeE'TrA 11Y�u`ee+oLu CONTRACTOR,.,.'t
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Name _._ _ Name: MICHAEL GOODWIN
Address: 3&4 Company: JENSEN BEACH ALUMINUM
State: Address: 1720 NW =EDERAL HWY
City: � _
Zip Code: Fax: - City: STUART State: FL
Phone No. -7-7Z- 4 S5-- A) Zip Code: 34994 Fax: 692-9744
E-Mail: Phone No. 692-0090
Fill in fee simple Title Holder on next' pts;;e; (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.: S ECORDED Notice of Commencement is req,•jired.
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SIJpPL�IVIENTAL CQNSTRUCTIQN LIEN LAW
INFaRMATfQN
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DESIGNER/ENGINEER: = Now+Applicable
MORTGAGE COMPANY: Not Applicable
Name: % E%11N� L1_L!
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Name:
Address:�� -7-A/14JAWO y2A9L
Address:
City: FC, G4fh2t,aTTr- `''` StateRk-
City: State:
Zip: Phone: �l'S`yi ,?�i/—
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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I certify:that no work or installation has comr-ienced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a ermit will authorize the permit holder to build the subject structure
which is in conflict with any applicable -Home •9wners Assocratlon rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Ov rers Association and review your deed for any restrictions which may apply.
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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 applicatior s':are exempt from undergoing a full concurrency feview: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to anot er on -residential use
WARNING TO OWNER: Yo r fail re ' ecord a Notice of Commencement m 'res i yJr paying twice for
improvements to y r pr e otce of Commencement mu r rd osted on the jobsite
before t Irs in ec ' n. tend to obtain financing, con It I' a an attorney before
comm9ricing W o ec ou:r IJotice of Co menceme
r,as Agc.:Itrfor Owner
STATE OF FLORIDA i`"6
COUNTY OF mil' (iC1� "'-' ' t(--
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The forgo( instrument was acknowledged before me
thi,,_ 1y of �- 20/0_6y
is
(Name of person. acknowledging)
(Signa0u Notary Pu-BEE- Stafe of Florida
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Personally Known �_/11' OR Produced.!dc itification
Type of Identification Produced _a
Commission No.
ANN M. DAUMOND
Holder
STATE OF FLORIDA
COUNTY OF SST .l—[]C1�
The forgoiQg instrument was acknowledged before me
thip�72 y of /�= 2Ole by
(Name of person acknowledging )
(Sign atureotary PUbIIC- State ofFlorida )
Personally Known ze_� OR Produced Identification
Type of Identification Produced
Commission No. (Seal)
" *- My COMMISSION # FF 173907
EXPIRES: December 7 2018 EXPIRES: December 7, 20t8
Revised 07/ 151201 �' od Bontled Thru Notary Public Underwriters :;i ., �P,.°
_ pF f Bonded Thtu Notary Public Underwriters
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