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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
*
Date: SCANNED Permit Number: 79
BY
St. Lucie County
Building Permit Application
Planning and Development Services I R
Building and Code Reguiation Division /JqA
2300 Virginia Avenue, Fort Pierce FL 34982 ?0�B
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residentih-mite
Address: -73,5o S Oc " -Pe- 4u q A. '
Legal Description: Dupigwai,4 3,, ;—rtW ocewo UA Sktio
UNiJ-
PropertyTaxlDti:
Site Plan Name: JT9 ok—l"
Project Name: 9rl_A-+'V
Setbacks Front N d Back-.`_
DETAILED DESCRIPTION
( oa 3G7 r-
1. op5-1- cDco-7
371 - 5479 -
1 Right Side: Left Side: A, 4
CONSTRUCTION INFORMATION,-*,
Lot No.
Block No.
Additional work to n
E1HVAC
-
ertormed unaertnispermit—cneCKau
Gas Tank.i_??', E]Gas Piping
apply:
Windows/Doors
_Shutters
Electric
[:]
Plumbine -,- _
Sprinklers
Generator
Roof
Roof pitch
Total Sri. Ft of Construction: F: _ S Ft. of First Floor -
Cost of Construction: $ Af Utilities: _ Sewer E Septic Building Height:
OWNER/LESSEE: :
CONTRACTOR),,:,', .
!/E-NA( -- ----
-Name: MICHAEL GOODWIN _
Address: 738o S or,6%_1vl>2 ` 4/9
Company: JENSEN BEACH ALUMINUM
City: "lt t State:—
T
Zip Code: 3Ngi1 Fax: AT!'- 7`f(Y
Phone No. N9i-Nv 39 `
Address: 1720 NW FEDERAL HWY
City: STUART State: FL
Zip Code: 34994 Fax: 692-9744
Phone No. 692-0090
E-Mail: r
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above) ; '
E-Mail: MICHAELI_GOODWIN@YAHOO.COM
State or County Licejise: CGC 1508437
If value of construction is $2500 or more —a RECORDED Notice of Commencement is required.
L
SUPPLEMENTAL'CONSTRUCTION`LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
.E7Ulo- G
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: I3L3o T$ru sY
M� cw'e: tJi
Address:
City: OLAagn4 4M
Zip: �_Phone: /729)
State: �
532-17om
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 corpmanced 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 applicati
accessory structures, swimming pools,
WARNING TO OWNER:
improvements ou
before the fir i p cI
commer wo r rfi
undergoing a full concurrency review: room additions,
creen rooms and accessory uses to another non -re idential use
:ice of Commencement /resiny ur ymg twice for
nencement must be ` Ady d on the jobsite'
financing, consult It r n orney before
60
STATE OF FLORIDA `" STATE OF FLORIDA
COUNTY OF ST OC1E :'.. COUNTY OF S7 Gi✓/F
L 1
The forg Ing instrument was acknowledged before me The forgoin instrument was acknowledged before me
th{j y of 1 77�C�f . `20Z:!&y thit�� a of �iP� , 20 �by
jrti is M
LT/9%1%1Z
(Name of person acknowledging )
-, ::
��
iidl#p
(Signature o otary Pub'�ic- Stag-pf
Flo(it{a,).
Personally Known ,-OR Produced Identification
Type of Identification Produced
Commission No.
(Seal).
(Name of person acknowledging)
(Signature otary Public- tate of 'Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. (Seal) III
, ' EXPIRES: Vecember 7, 201a ill.'.,: MY COMMIS ION d FF 173g07
Revised 07/15/2014. _:,,;?;. F'c?V Bonded,76m NoMry Public UndeNliters %S+, .`a= EXPIRES: December 7, 2018
,or, rt,+ Bonded Thin NOL-ry Publ'e UndenvrAers
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW `
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
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