HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 110151 �� SCASNNED Permit Number:
- , , ^ - - • ; St. Lucie County
o _
Building Permit Application RECEIVED
Planning and Development Services JUL 2 4 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Se County, P@rmltNflg
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Resi en i'SI
Address: I Z 1- O S A- —) n413 L_ -`ib' 7-05`
Legal Description:
\I ( S 1-4 5 �—j
Property Tax ID #: n3 y -M - SOa — D166 —� — l Lot No.
Site Plan Name: / �f7/t//(DLO Block No.
Project Name:
Setbacks Front N A Back: N P- Right Side: N A Left Side:
DETAILED,DESCRIPTION OF WORK:
�HVAC
❑ Electric
0 Plumbing
Windows/Doors
Roof
Total Sq. Ft of Construction: Sa} —F�t. of First Floor:
Cost of Construction: $ ��� Utilities:'nSewer Septic Building Height:
,OWNER/LESSEE.
CONTRACTOR:
Name V A0-PA7
Name: MICHAEL GOODWIN
Address: /Z l
Company: JENSEN BEACH ALUMINUM
City: A4— St L_Jcitr State: F_
Zip -Code:- ;Y'i 1" -L Fax:
Phone No.�1� (�92 �fl n
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: N uy
Not AppAlicable
vON
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
,Von U
Address:
City: 6✓
Zip: Phone
State:
Y Z 400a
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your fai to Record a Notice of Commencement may resu t i our paying twice for
improvements t to your e Notice of Commencement must be recoX osted on the jobsite
before the f' st in ect' n If intend to obtain financing, co ulul`I1/wr/tyi ln at
before
comme ne or ec vour Notice of Commenc
s
Signature of Owner/Lessee/Contracto s Agent for Owner Signature of Contractor ' ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFST I�UGIE COUNTY OF__c�-i .4_0c/E
The forgo,,,,in,gg instrument was acknowledged before me The forgoing instrument was acknowledged before me
thia3'�da'y of --r,)q 20 /ef— by thj c3"ay of QjG 20 ZC�E by
(Name of person acknowledging) (Name of person acknowledging)
(Signatu -of Notary Public- State o Florida) (Signature i-Nob tary Public -State of Frooraa )
Personally Known --' OR Produced Identification
Type of Identification Produced
Commission No.
M.GAUMOND
Revised`07/15/20
Personally Known &" OR Produced Identification
Type of Identification Produced
Commission No.
MY COMMISSION 4 FF 173907
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