HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONf_.
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �OIa I�`� SCANNED Permit Number: (n 0D3
BY
``1 St. Lucie County
e .
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
Address: Ifl(o Oo S oGe4" -Dates -''
Legal Description:
Property Tax ID #:
Site Plan Name:
usS —"UCa)
Lot No.
Block No.
Project Name:
Setbacks Front N A- Back: ti A- Right Side: NIA Left Side: ti L}-
{ DETAILED DESCRIPTIONOF' WORK:
-CM4 4C-T-
NUUILIVI 101 WVIK to ue J I U I IIICU wwo LIM 1JCI I I I IL—UICUM au Opply.
❑HVAC Gas Tank ❑Gas Piping
Windows/Doors
_Shutters
❑Electric
El Plumbing
[]Sprinklers ❑Generator
_Roof ❑ Roof pitch
Total Sq. Ft of Construction:
Sct. of First Floor:
Cost of Construction:
$ G%M,
Utilities: Sewer ❑Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
N Ot7.A'
Name: MICHAELGOODWIN
Address: iO&oc-, S JDjaY e wj t7
Company: JENSEN BEACH ALUMINUM
City: ItState:
Zip Code: Fax: mot'
Phone No. 1—� l d
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 $2500 or more, a RECORDED Notice of Commencement is required.
1
,,;
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
-
DESIGN ER/ENG I NEER: Not Applicable
Name: ki/1711414M/iVEE31.f
MORTGAGE COMPANY: _ Not Applicable
Name:
Address Mf?j2%N_-A s'<isv�y n�.r //o
Address:
City: State: f��
Zip: — Phone: 4(t)��
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLD : Not Applicable
Name:
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 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 ditions,
accessory structures, swimming pools, fences,.. , signs, screen rooms and accesso uses to anothe n -residential use
WARNING TO OWNER: Your failuje t cord a Notice of Commence nt ay resu I r paying twice for
improvements to your progerty/A Ice of Commencement mu berde a osted on jobsite
before th sins ctio if u n nd to obtain financin , co uIt I en r r n attorneybefore
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST A_V CZO�_= COUNTY OF S'T I_OCI.5
The forgt;Ii instrument was acknowledged before me The forgoin instrument was acknowledged before me
Iftof cSE,4T 20/�by th�j7�of cS�.oT 201� by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public -State of Florida) (Signature aFNo-tary Public -State of Florida )
Personally Known OR Produced Identification Personally Known 1/ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commissionallo.
Revised 07/15/2014
173907
7,2018
Commission No.
173907
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