HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: • 2,4'• IQ SCANNED Permit Number: -
- St. Lucie County Qr-r"EIVED
Building Permit Application JUL 2 6 2019
Planning and Development Services
Building and Code Regulation Division ST, Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982 y
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 IMPROVEMENT LOCATION:.
Address:
Legal Description:
'(alE /,Ur 13
Property Tax ID #: NSI — SO. — Cad _ oDb— ( Lot No.
Site Plan Name: Z212Ayl Block No.
Project Name: R)
Setbacks Front/a Back: Right Side: Left Side: �` G
DETAILED DESCRIPTION OF WORK. -/.
CONSTRUCTIONINFORMATION:._
Additional work to e nertormed under tispermit—check all apply:
OHVAC Gas Tank OGas Piping Shutters 0 Windows/Doors
Electric 0 Plumbing Sprinklers Generator 0 Roof = Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $
32�0
S Ft. of First Floor:
Utilities:CnSewer 0Septic Building Height:
—OWNEOLESSEE: '.
CONTRACTOR:.
Name —,A —A
r A/
Name: MICHAEL GOODWIN
Address: ((C' 424122- /,.k)
company: JENSEN BEACH ALUMINUM
City: pvCOv lteAC,+ State: GL '
Zip Code: 3M GT Fax:
Phone No. 87-8)y82.'1273
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: Ftov& At A-
yIVN+rNUAA EN61Nogu#JL
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: 4H S -rAM ,arM i
Ty2orI L. ff i I
Address:
City: _ pow lSt+A ✓�WTT
Zip: Z,!n Phone: 9ui -
State: JFt,
3R/- FJ5a
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
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 are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fenc s, walls, signs, screen rooms and accessory uses to anothe/non-r i ential use
WARNING TO OWNER: Yo r f ' u Record a Notice of Commencement may result in yin twice for
improvements to your p��otice of Commencement must be worded anti pn the jobsite
Notice of Commencement.
s
Signat mo Owner/LessegtVontractorasAgentforOwner
'gnat eof ontract /License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF _ ;J:
COUNTY OF E
The for �0A1' g instrument was acknowledged before me
OR
The forgo' instrument was acknowledged before me
thl, �8'dy of TUG—� 20`_9 by
y of U J)ZY , 20/_5� by
(Name of person acknowledging J
(Name of person acknowledging
/)�>+�
(Signature of Notary Public- State of Florida)
(Sign ature-UMotary Public- State of Florida )
Personally Known OR Produced Identification
Personally Known ✓ OR Produced Identification
_,/"'
Type of Identification Produced
Type of Identification Produced
Commission No.
Commission No.
,:«:'et"g.�-.,• MN M. GAUMOND
: feW.. ANN M. GAUMOND
-
>4• 'a
' ' December7,202
1EXPIRES:
07/15/201
rshRevised
Pt SwwTt= PubrcUadeR
mEXPIRES:December7,2022
yPubBoUMew
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS