HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED F.QR APPLICATION TO BE ACCEPTED
Date: C Permit Numb 16
SCANNED Kt:Lt
BY
St. Lucie County SEP I
BUilding Permit Applicatio ST.Lucieloun
Planning and Development Services
Building and code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: I c; ZOL-> :j e) CeE7,2�/ 7-)ez- G I
Legal Description: k1LAr,-rIS Iti '13:7 -r� .1;'g:W tao(6 A*% 0 Rsu 5�ATA.
'9�4� 1/" rov�mo�- (opt
Property Tax ID #: 4 - 51 C3 - DP5LY — 00 U V Lot No.
Site Plan Name: if I L't, Block No.
Project Name: 14 1 L L-
Setbacks Front IL/M- Back: RightSide: Left Side:
J,PET�ILED
DESCRIPTION OF WORK:,
"CONSTRUCTION INFORMATION:
AdditionalworKIODeperturnied under this permit ---check ail apply:
11
0 HV Gas Tank E]Gas Piping Shutters Windows/Doors
11 Electric Ej Plumbing OSprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft of First Floor:
OSeptic
Cost of Construction: $ 5,6 t'.' Utilities: Sewer Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name I L�L- ai;rm &—LT
Name: M1CHAEL GOODWIN
Address: 0 7)
Company: JENSEN BEACH ALUMINUM
City:_ (A(A-'t-4aL-r7)vJA) State:
Address: 1720 NW FEDERAL HWY
City: STUART State: FL
Zip Cocle. 0 C-� Fax:
Phone No. dc'-� rs- 8 1 yr—
Zip Code: 34994 Fax: 692-9744
E-Mail:
Phone No. 692-0090
Fill in fee simple Title Holder on next page ( if different
E-Mail: MICHAELLGOODWIN@YAHOO.COM
from the Owner listed above)
State or County License: CGC 1508437
if value of construction is $2SOO or more, a RECORDED Notice of Commencement is required.
1� k
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: —1
btsIG N ER/ENG1 NEER: — Not Applicable
Name:— ;7L-0410A &&&"'U 68//V
City:
Zip:
ne:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: —
Phone:
MORTGAGE COMPANY:
Name
— Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY: —Not Applicable
Name:
Address:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Coun makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conlylict 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 failu Record a Notice of Commencern It It n' ir ayingtwicefor
o you 'e' may r:"u
improvements t_nsj ec� Pp oticeof Commencement must The record da dpZFeiclonthejobsite
tpr
before the ft in end to obtain financing cons ith I er r torney before
commen W 0 e r our Notice of Ciommencer�en
ignatur.eof n
ignature of Contractor it nse Holder
er/Lesse MContract =E:z �
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF COUNTY OF
Theforg" instrument was acknowledged before me The forgoing instrument was acknowledged before me
thiV Uig 20/L—by this/5'��v of 5�0,07_ 20/,f— by
!K"
ft of
(Name of person acknowledging (Name of person acknowledging)
(Signature'ofNotary Public- State of Florida
Personally Known OR Produced identification
Type of Identification Produced
Commission No.
J! FF 173907
Revised 07/
(Signature oMtary Public --State of Florida
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
ANN M, GAUMOND
MYC0V.M1SSl0N#FFt
Bonded
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
-REVIEW,
VEGETATiON
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS