HomeMy WebLinkAboutBUILDING PERMIT APPLICATION2i"
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED a-7
Date: C\\. vd'�\ SCANNED Permit Number: 1�d9 d3 1 f
BY
` ` J St. Lucie County =County,
0
Building Permit Application
Planning and Development Services
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: To Select from dropbox, click arrow at the end of line Cc Y Aa III
Address:
3tc17 tJ
I%t6i+ovAq
AtA
1PN-or01
Legal Description:
SA'-JI95
oN -rH
OCEir+J
Sg-rnoJ I Lim tT-'P*ArI (t)✓L trait 113T
Property Tax ID#: %Ob- DO'1-7- bob-8 Lot No.
Site Plan Name:
Project Name: 010 j1V
Setbacks Front. Back: HRight Side: HA- Left Side: �.�
Block No.
DETAILED DESCRIPTION OF WORK:' 'll
CONSTRUCTION INFORMATION:
AClaitionalworKtOrie errormed under tispermit-check all apply:
❑HVAC Gas Tank ❑Gas Piping _Shutters ®Windows/Doors
❑ Electric ❑ Plumbing []Sprinklers ❑ Generator ❑ Roof ❑ Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ l l.I Zoo SRt
5 Ft. of First Floor:
Utilities:'n5ewer❑Septic Building Height:
OWNER/LESSEE:
`
CONTRACTOR:
Name A'W a'Ll C 4 Q171tC"'1i}
Name: MICHAEL GOODWIN
Address:t(�,'A oo N '{f1 b�W /n! -41 R-- i91fA01
-Company:=JENSEN,BEACH,ALUMINUM___
City: J tGt+- A_yc ni =TL_jk- n State: Pt-
Zip Code: 34q Y`) Fax:-
Phone No. (S, Z)31�'- bt"6
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 52500 or more, a RECORDED Notice of Commencement is requireu.
SUPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION:
Name: jL4kL 1pL1 Q(UMINUM I`�/i lnlc�lu�16
Address: swy o MA✓GrniOL sr- #� Il o
City: Stater
Zip: PWI,o4 Phone: (arfl-240
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip:
Phone:
MORTGAGE COMPANY:
Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
Zip:
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 additi
accessory structures, swimming pools, !yn,*s, walls, signs, screen rooms and accessory uses to another nyn- idential use
WARNING TO OWNER: You fa' to ecord a Notice of Commencement may resul y aying twice for
improvements to your pr e A tice of Commencement must be r rded d ed on the jobsite
before the first in p i u i end to obtain financing, consult d r orney before
commen ' w r co ur Notice of Commencement.
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Signature of Owner/Less e/ ntractor as Agent for Owner Signature of Contractor ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The for of instrument was acknowledged before me The forgoinginstrument was acknowledged before me
this/ of SEAT 2q/�by thiV of_'5-c07— 201C� by
(Name of person acknowledging j (Name of person acknowledging)
�—,�..=c��s_=e�=_�61�ii11/r�iv./J/
(Signature otary Public- aPublic- to of Florida) (Signatur otary Public- State of Florida )
Personally Known �V1.1, OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
MY COMMISSION s FF
Sanded Thin
Revised 07/15/2014
ANN M. GAUMOND
EXPIRES: December 7,20111
8
Bonded Thor Notary Public Undervaders
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