HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONf
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date: 3 @ Permit Number:
RECEIVED
-- — -— Building. Permit Application MAR 12 2019
Planning and Development Services
Building and Code Regulation Division sT, Ludo county, Permltting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: VISTA T)U, ZoL BY
Legal Description: St. Lucie County
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,: 375-t -Z�L
Property Tax ID#: ax�yLi3 Q_ Lot No.
Site Plan Name: Sf% NI°r7✓iil, Block No.
Project Name: Sil'n F'iI0
Setbacks Front N 0 Back: a Right Side: r' h Left Sider
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CONSTRUCTION INFORMATION:
itiona wor to e e orme un ert ispermit-checka ; atapply:
❑HVAC nGasTank ❑Gas Piping _Shutters Windows/Doors
❑Electric ❑ Plumbing []Sprinklers ❑ Generator LJ Roof ❑ Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ S;ZG G�l
StI�Ft.� of First Floor:
Utilities: nSewer ❑Septic Building Height:
:OWNER/LESSEE:`.
CONTRACTOR:
Name MAa4r c rn LP 01
Name: MICHAEL GOODWIN
Address: 32 Lf Vg- VISrA- it2L 'J�- Z4>Z-
Company: JENSEN BEACH ALUMINUM
City: 51- L-Vc-IC�' State: F1,
Zip Code: 3 49 iZ Fax:
Phone No.
Address: 1720 NW FEDERAL HWY
City: STUART State: FL
Zip Code: 34994 Fax: 692-9744
Phone No. 692-0090
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: MICHAELLGOODWIN@YAHOO.COM
State or County License: CGC 1508437
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name: No✓e4(5
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: _ Phone/
Stater_
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLD :
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 re exempt from undergoing a full concurrency review:
accessory structures, swimming pools, f,ohees, walls, signs, screen rooms and accessory uses to ary
use
WARNING TO OW ER: Your a to Record a Notice of Commencement ay re paying twice for
improvements t u pro A Notice of Commencement mu cor sted on the jobsite
before the firs In p do y u intend to obtain financing, co sul h I o attorney before
commencin o re o i our Notice of Commencem t.
Signatur of wner/Less Contractor as Agent for Owner to a of Contr License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF- COUNTY OF �TC��
The forgo' instrument was acknowledged before me The forgo' instrument was acknowledged before me
thi;/� 6a� of ^ G//i�CJ 20 / by this/oz of I mXr..4} 20 / by
(Name of person acknowledging) (Name of person acknowledging )
(Signature of Notary Public- State of Florida) (Signature f Notary Public- State of F�da )
Personally Known ✓ OR Produced Identification
Type of Identification Produced
Commission No.
ANN M. GAUMOND
MYCOMA(ISSION i GG 269714
Revised
Personally Knowny OR Produced Identification
Type of Identification Produced
Commission No.
ANNALGAUMOND
SORES: December T. 2022
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