HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:. \ 5, \d SCANNED Permit Number: \ � \ � � d � C)
BY RECEIVED
St. Lucie County
Building Permit ApplicationLNOV 0 6 2M
Planning and Development Services tle Etltiljf. e f er%111
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 C 6 h I e,
I PROPOSED IMPROVEMENT LOCATION: I
Address:
Legal Description: 51� CpyfryoS CoWOo 6V7- /�9 0/L 78r %'L-7 /q3Z -(vYS
Property Tax ID #: f/S-OZ' Buy— w9r�- 000-3 Lot No.
Site Plan Name: %iNQ�7 ^� Block No.
Project Name: 1;—fA l2 "A!V
Setbacks Front Back: A10- Right Side:
LeftSide: NI
k11A,,9&J RWv1#2 ,17 /z/ 0/iew/L &5
A00monaiworKtooe errormea unuermispermit— cneLKall
E1HVAC ❑Gas
Mutters
®Windows/Doors
_Gas Tank
Piping
_Shutters
Electric OPlumbing
Sprinklers
1:1Generator
Roof Roof pitch
Total Sq. Ft of Construction:
ScFt.
of First Floor:
Cost of Construction: $ scJ
�
c?7
� Utilities:
_Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: MICHAEL GOODWIN
Address: 1 22 C gI i6-5 !SE_
Company: JENSEN BEACH ALUMINUM
City: 1141L l 11AW State:'V
Zip Code: Oio If I Fax:
Phone No.
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.
3
SUPPLEM, -NTAL CONSTRUCTION LIEN LAW INFORMA,,
_m .
oN:
DESIGNER/ENGINEER: _
Name: GYowoA A1t1W/4WM
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: M
Address:
City: u
Zip: ?p cu = Phone: 51
State: r--L_
?7'f-2r�U2
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your 51r,
o Record a Notice of Commencement may res i ur paying twice for
improvements to your propotice of Commencement must recorde osted on the jobsite
before the ' tow(
ins ecti n.nd to obtain financing, con t ith ten e o an attorney before
comme 1n o or c r Notice of Commenceme
s
Signature of wner/Lessee/font a or as Agent far Owner ignatur of Contractor/ icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNT 1C TY OF SVC�E COUNTY OF
The for ng instrument was acknowledged before me The forgoing instrument was acknowledged before me
thiE day of / 201Sby thig'J004ay of A%/J//«! n 20le by
�� e)/t)
(Name of person acknowledging) (Name of person acknowledging )
���/oI®//ri9PrQsA,� C/!ilf- ftt'���C 7 Florida
(Signat otary Public- State of Florida) (Signatures a of'N tary Public- State —of Florida )
Personally Known _Z OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced I Type of Identification Produced
Commission No.
Revised 07/ 15/2014
ANN M. GAUMOND
EXPIRES: December 7,2018
Bonded Thm Notary NYC Undewritet
Commission No.
ANN M.
EXPIRES:
Bonded Thm f
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