HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONG \ L
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/10/2017
Permit Number: 11 al' d 1� M
RECEIVED JUL 112017
-_- SCANNED
Building Permit Application BY
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Concrete t�ifi�rtvf_��o .-� F-) III
I PROPOSED IMPROVEMENT LOCATION: III
Address: 10410 S Ocean Drive, Apt 1102, PH3, Jensen Beach, FL 34957
Legal Description:
Property Tax ID #: 4511-514-00$4-000-1 Lot No.
Site Plan Name:
Project Name: Goode Residence
Setbacks Front Back: Right Side: Left Side:
Block No.
DETAILED DESCRIPTION OF WORK: III
Trench floor ,Repair
CONSTRUCTION INFORMATION:
Aaaltional work to be nerformed under tispermit—check all apply:
E1HW Gas Tank ❑Gas Piping In Shutters ❑ Windows/Doors
ElElectric 0 Plumbing Sprinklers D Generator F—] Roof = Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 1500.00
Spy —F—t.� of First Floor: _
Utilities: LJSewer Eheptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Namefidian L Goode
Name: Michael Roberts
Address:10410 S Ocean Drive, PH3
Company Speca Forces
City: Jensen Beach State:Fl-
Zip Code: 34957 Fax:
Phone No.734-476-8583
Address: 1235 NE Dixie Hwy
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No. 772334-2990
E-Mail:ALLANLGOODE@GMAILCOM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:
State or County License:
It value of construction is 5Z500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name: D'xigrd Davis Ardidecl, PA
Address:1045 SE Riverside Drive
City: Stead State:
Zip: 34995 Phone: 772-7e+-6e95
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name: _
Address:
City:
Zip:
7rTOin
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the fir5t�inspecction. If you intend to obtain financing, consult with lender or an attorney before
as Agent for Owner
STATE OF FLORIDA STATE OF FIL A
COUNTY OF 1�l7G�{�/ /� COUNTY OF i►'l�l-f7r1
The forgoing instru a was acknowledged b fore me The forgoing instrument was acknowledged before me
this / U day of _ _ /.L & 20 / lby this -iLZ day of �' L L� 20 L= by
141'1,51�n (7Doa'2. Mtr_o'g0_i
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public -State o Florida )
Person Ey""'O"Type oCommi - Commission # FF 033
one roug ational Notary Assn.
Revised 07/15/2014
REVIEWS I FRONT I ZONING
COUNTER REVIEW
TSignature of Notary Public- State of Florida }
Personallynow I Ica on
np,...� bg k1i� £R
Type of Id tj#i Vro 4is--- State -e7cid
_ ' • 2 My Comm. Expires Jul �222, 2017
COmmissl0 �u': ion # FF 01 eMQ
Bonded Through National Notary Assn.
SUEGETATIEATURTANGRO
PERVISOR
RE EW// I PLANSVREVIEWON I S REV EWLE MREV EWVE
INITIALS