HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICAB4ji)NIF I LIST BE COMPLETED FOR APPLICATION TO BE ACCEPI Eta
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Date: ,' BY Permit Number:
St. Lucie County
RECEIVED
Building Permit Application JAN 2 2 Z018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT APPLICATION FOR: To ISICIect from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCtiTION. +` "
Address: 9650 S OCEAN DR APT 903,JENSEN BEACH , FL
Legal Description: THE PRINCESS OF HNTCHINSON ISLAND UNIT 903(451-1161, 626-2567; 867-2277)
r$e 16
Property Tax ID #: 4502-610-0083-000-1 Lot No.
Site Plan Name: BURTNIK Block No.
Project Name: BURTNIK _ Is
Setbacks ,Front NIA Back: WIR Right Side: NIA Left Sideli q/A
DETAILED DESCRIPTION; IF WOl`iC
DOOR, REPLACEMENT ( 2 SL1DIuJG DOORS WITH EXISIT SHUT TERS)(NONIMPACT)_
r .
CONSTRUCTION INFORMATAnl1n
Additional work to be nertormed uide[t ispermit—c ec a apply,
In
EjHVAC Gas Tauk (Gas Piping _ Shutters Windows/Doors
Electric OPlumbing a5prinklers Generatorr Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 9500.00 Utilities: Sewer oSc ptic Building Height:
„•.
OWNER/LESSEE
CO'NTRACTOR;;
Name BURTNIK ERIKA
Name: MICHAEL GOODWIN
Address: 9650 S OCEAN DR APT
993,:1
Company: JENSEr,i BEACH ALUMINUM
City: JENSEN BEACH
Zip Code: 34957 Fax:
Phone No.229-1393
".— FL
—,- State: _
+=
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)
:7^
E-Mail: MICHAELL.;_OODWIN@YAHOO.COM
State or County Lic-!nse: CGC 1508437
IIIf value of construction is $2500 or more, a RECORDED Notice or Lommencemem: is regJ,rea. II
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: , City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone: ='i=
Zip: _ Phone:
i' if I
I certify that no work or installation has commenced prior to the
issuance of a permit.
St. Lucie Countyymakes 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 application siar ' x mpt from undergoing a full concurrency review: room additions, ,
accessory structures, swimming p s, fen e ; Ils, signs, screen rooms and accessory on -residential use
WARNING TO OWNER: Ya f ' u o ecord a Notice of Commencemerp m'r paying twice for
improver our r Lice of Commencement must be re411ted on the jobsite
before the firs I sp� I i ehd to obtain financing, consult wi torney before
cnmmencine w rk 6d r or I v. ur-Notice of Commencement.
Signature of Owner/Lessee/Contfacl; �wner signature raaoqucense nuwer
STATE OF FLORIDA "g STATE OF FLORIDA'
COUNTY OF e COUNTY OF�C'1` L�J%C1 C
a .r
The for o' instrument was acknowledged before me The forgoinginstrument was acknowledged before me
thi5/� of ,% � . 2l}!S_by this/ of r/}� , 20�_ by
(Name of person acknowledging )"
(Signature -of -Notary Public- State of Floridaf) Tt.
a'U
Personally Known I OR Produced Identification
Type of Identification Produced-1 -
Commission No. f—
r • f;;,01M. GAUMOND
r y rl�a `a MN601MMISSION # FF 173907
Revised 07/15/2014
(Name of person acknowledging)
(Signatu f Notary Pub is -State of Florida )
Personally Known .% OR Produced Identification
Type of Identification Produced
Commission No.
ANN M. GAUMOND
EXPIRES: December 7, 2018•
Bonded Thm Notary Public Underxritem
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