HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number:\
BY
St. Lucie County
Planning and Develapmen I t Services Building Permit Application SEP 18 2018
Building and Code Regulation Division ST LLucie C�un��, en-1
2300 Virginia Avenue, Fort Pierce FL 34982 _P
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line SIA ok�M C_5 I
PROPOSED IMPROVEMENT LOCATION:
Address: on LAVw:,' y( s-#--A- --ilk, 47fo-1, i
Legal Description: %J -,�Tnff 5-7- L�Jr_ljg� 2?1,jj� '7�5 'J&,1 r- arz- 7diff
Property Tax ID #: %f -z I- - Sc> ,> - C)'3 1 b - 00 0 Lot No.
Site Plan Name: C) Block No.
Project Name:
Setbacks Front IVIA- Back:
DESCRIPTION 0
116pavtl�
L-AL Right Side: /--/—X Left Side: I%--IA-
4C e- o (A-"'-f
CONSTRUCTION INFORMATION:
AaClitional worK to De nertormed under this permit -check all that apply:
Gas Tank ElGas Piping IKShutters Windows/Doors
Electric Plumbing []Sprinklers ElGenerator E]Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 5yon .90
S Ft of First Floor:
Utilities,cn Sewer E]Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name rit) 407 1-19atna
Name: MICHAEL GOODWIN
Address: Ll t/esr)q Tx4_ 102-
Company: JENSEN BEACH ALUMINUM
City: — 2fe?A-r >T7 L�Jc-fe:�_ —State: f:7L-
Zip Code: Fax:
PhoneNo55(-:(
Address: 1720 NW FEDERAL HWY
City: STUART State: FL
Zip Code: 34994 Fax: 692-9744
Phone No. 692-0090
E-Mail:
Fill in feesimple'ritle Holderon 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.
-SUPPLEMIENTAIL CONSTRUCTION LIEU LAW INFORMATION,'
DESIGN ER/ENGI NEER:
Name: Ftcyvt,,OA� Ata&wmm
Address: <L?41n MAWaA&1L
Not Applicable
5)4o-,'X �!-tffj
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: - -ThWIR-
Zip: _3%*j�_Phone: 8(3-
State: _E1111-
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 commenced prior to the issuance of a permit.
St. Lucie Coun makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conlylict with any applicable Home Owners Association rules, bylaws or ang covenants that ma estrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions yhichmayapply.
w
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 add*t' S'
�Is, signs, screen rooms and accessory uses to anothe lal� sidential use
accessory structures, swimming ols, fences, a
po'
WARNING TO OWNER: Your failur o
e - 9 ®rda ctice of Commencernent may result i paying twice for
f cir� nt may result
improvemep��sMq your prope 0 ce � b�ar myi�t b r c cled ted on the jobsite
f/7
3) t attorney before
before theffrst i0spgictioryl A n 7nd 9-6sult �it r5 9
as Agent
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF I C 0 U IN TY 0 IF 5;:�7
The forgo* g instrument was acknowledged before me The forgg_'Dg instrument was acknowledged before me
thi,—%Y of 20 /_'5_1y � thi/,f!�-Ry o 20 1,,f- by
��ajzz) � /e/c//ort-t:�
(Name of person acknowledging) (Name of person acknowledging
(Signatur-emf-Motary Public- State of Florida (Signature-of-Netary Pubric- Stai-e—of Florida
Personally Known V__'�OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
N t
otary
FF 173907
Personally Known ZZ_ OR Produced Identification
Type of Identification Produced
Commission No.
Bonded
GAUMOND
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS