HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: C ' j - / SCANNED Permit Number: _ 1 /p
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St. Luce County REC'EIVED]
Building Permit Application FEB 2 1 2019
Planning and Development Services
Building and Code RegulationDivision Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 {; I I I �.� County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial 139-d6W80
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
Address: iO(,oa S Q ogr — k�-'7
Legal Description:
Ao /I
Property Tax ID#: c1f7/-S/7-6C57-0(20-7
Site Plan Name: 4401?V-IN5
Project Name: N�0 PAIN S
Setbacks Front N10" Back: t t Right Side: r A- Left Side: N A
HVAC LJ Gas Tank UGas Piping
Electric 11 Plumbing []Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
41J0, o0
I bper.0A^,(. ::J:n^PA4C,<
Lot No.
Block No.
aPP Y�
Shutters ❑Windows/Doors
Generator 171 Roof = Roof pitch
S Ft. of First Floor: _
Utilities.. Sewer 0Septic
Building Height:
CONTRACTOR:
Name . L S
Name: MICHAEL GOODWIN
Address: InG..0 4 mw,
-pk ,kk7
Company: JENSEN BEACH ALUMINUM
City: 5FA( 0EAr f
Zip Code: oFax:
Phone No. 0?02�1 �l / °l'1
State: 1_C.
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 or Lommencement is required.
„SuPPlEN1ENTALCONSTRUCTION LIEN LAWIRMATION
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name: yLa2/YY A/drHiA14wx4
tU/a69&A1&
Name:
Address: S4 114
/ie
Address:
City: A
State: rC—
City:
State:
Zip: !!a Phone:r
7 —
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Address:
City:
Zip: Phone:
Name: _
Address:
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 r re to Record a Notice of Commencement may result in r paying twice for
improvements to Yourpr p . A Notice of Commencement must be orded a s ed on the jobsite
before the first ins ct 1 ou intend to obtain financing, consult it d orney before
comm or ore our Notice of Commencement.
s
Signature of Owner/Les a ontractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFF j I-VCd1—C COUNTY OF
The for of instru nt was acknowledged before me The forgoinginstrument was acknowledged before me
thisl! `Msv of 2% —by this ay of 20 by
-/Cf1,A99EL- eeJI, /LiC�f�9�� �T�1Jtc>!2J
(Name of person acknowledging) (Name of person acknowledging )
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Personally Known Z' OR Produced Identification
Type of Identification Produced
Commission No. (Seal)
Revised 07/15/201 ; &- EXPIRES: December 7,2022
Personally Known ✓ OR Produced Identification
Type of Identification Produced
Commission No.
ANNM.GAUMOND
EXPIRES. December 7, 2022
Bon Thm Rotary PUNC WenMters
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