HomeMy WebLinkAboutBUILDING PERMIT APPLICATION1`
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: q' �� Permit Number: ` C \O L I' das 4
SCANNED
St. Lucie Count+! RECEIVED
Building Permit Application APR 0 9 2019
Planning and Development Services
Building. and Code Regulation Division ST. Lucie_ Countyi Permitting
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 �T1g55 �� III
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: rji- LUL#c (2 72f7M4 A(, 3L Vo 77f*r- a0AX r CPC :KLt,/ Am n Z
0): I/f f As 0`va.st,' at, 64 2,139— 77v cvr /rZ AecT N
Property Tax ID#: .342(0-Sao--/of9 -000/7
Site Plan Name: -_TA?V.E'-au.' SL' /
Project Name: T4-r, kGow SILT
Setbacks Front /Ja Back: N A- Right Side: /" 4 Left Side: /per
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
-- �XtSIT/Nb �►'l+ SHvr>�t��pper-Sc,r�2
Ei'1 f ITiN E64&0, I/✓a &2gZ37'Lf L
CONSTRUCTION INFORMATION:
Additional work to be nL ormed under tispermit-check all thatapply:
E1HVAC Gas Tank ❑Pipin1:1Gas g Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers E Generator D Roof Roof pitch
Total Sq. Ft of Construction: ScFt. of First Floor:
Cost of Construction: $ �o"Z+b Utilities* Ft
OSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name TES% 7;i'NA:0.54i
Name: MICHAEL GOODWIN
Address: /it/ii
Company: ,JENSEN BEACH ALUMINUM
City: WE 5T `(/Ll e' State:
Zip Code: 3f/9r7-- Fax:
Phone No. ij egy- 40//
Address: 1720 NW FEDERAL HWY
City: STUART State: FL
Zip Code: 34994 Fax: 692-9744
Phone No. 692-0090
E-Mail:
Fill in fee simpleTitle Holder on next page (if different
from the Owner listed above)
E-Mail: MICHAELLGOODWIN@YAHOO.COM
State or County License: CGC 1508437
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: —T� k1/io NaZe�S &W&/NE F;VA/ Name:
Address:_// f R4,4"J Address:
City: State: City: State:
Zip:-- Y�Phone: 4 —/0Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable I BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Name: _
Address:
City:
Zip: Phone:
_Not Applicable
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 andcovenantsthat 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 walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your f ' ' ec a Notice of Commencement result in o a in twice for
improvements to your P tic of Commencement must I r co ded a ed on the obsite
before the firs s e n e to obtain financing, consult th y er r�pattorney before
commencin wor QC ur otce of Commencement.
s
Signature of Owner/Less ontractor as Agent for Owner Signature of Contracto icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 7 /`f' J COUNTY OF ST
The for�9ing instrument was acknowledged before me The forgoing instrument was acknowledged before me'
this ay of 1J4Q/L 201by this k�y of 1WiQ/L 20/? by
/llcf14161— 4ClD�cc7�y
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public- State of Florida) (Signature oflfttary Public- State of Florida )
Personally Known _yl� OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. I Commission No.
y lL�y:,::i�.
Revised 07/15/2014
WCOAMSSION S GG 269714
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