HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FO APPLICATION TO BE ACCEPTED
Date:
-q -1. 6SCANNED
BY Permit Number:
St. Lucie County
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Building Permit Application,,,,.,,,.,,,. �
Planning and Development Services
Building and Code Regulation Division Sr c� ep
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2300 Virginia Avenue, Fort Pierce FL 34982 s �ac•� Meq f
Phone: (772) 462-1553 Fax: (772) 462-1578. Commercial X Residential
Address: to 15A 5 Dcow On— -0 71513 -7a 5aQeA{-
Legal Description:
FFrLAYV175- oo voo 860 13 diva- l fo? A-A./l PA A*M PW —
Property Tax ID #: // 0 Z - So?- co&o- mo— 6 Lot No.
Site Plan Name:
Project Name:
Block No.
Setbacks Front Back: O) Right Side: -A*—
Left Side:
DETAILED DESCRIPTION OF WORK:" '
Wirfcxx.J 4- paD¢ 0Wf -- Iq 2
2 w ►d-Gt .mac 15 rtvJe
3 6TTP;i_-
f, CONSTRUCTION INFORMATION: ,
;C iona work to e e orme under tIspermit—checka happy:
OHVAC 11GasTank []Gas Piping Shutters Windows/Doors
11 Electric El Plumbing Sprinklers Generator E Roof = Roof pitch
Total Sq. Ft of Construction:
00
Cost of Construction: $�
S Ft. of First Floor: _
Utilities: Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name l dQ L r-
Name: MICHAEL GOODWIN
Address: 101!5 SOCGa2y .. 2 719(
Company: JENSEN BEACH ALUMINUM
City: �T� ait'i{- State: FL
Zip Code: `, Y� rr�7 Q Fax:
Phone No. !i2 ` ` 17iI
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. \.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: r/ovGioA �iLr/R!l✓INl OUbi�t/ (1NU Name:
Address: 1p #f4Wj/YI�LSTne sue //o Address:
City: A Stater City: State:
Zip: 7 Phone: _ Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit
_Not Applicable
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 ano 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 application re exempt from undergoing a full concurrency review: room additions, _
accessory structures, swimming pools, ces, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO NER: Y ur re to Record a Notice of Commencement may r your paying twice for
improvement to our p op Notice of Commencement musWb r d posted on the jobsite
before the f st in cY n f intend to obtain financing, consue d r ey before
commenci g wo or c our Notice of Commencement.
s
Signatur Owner/Lessee/ ractor as A ent fo Signature of Contracto icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5'7— e��7C�l= COUNTY OF ST .CUC/,,_=
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ay of A'�4Y 20/�by this ky of !c +/ 20 � by
i
(2LIQL W1,41 AIiC_Aidl.E Y�Dli/i /2)
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public- State of Florida) (Signature f-Notary Public —State of FForida )
Personally Known OR Produced Identification
Type of Identification Produced
.........
un,+...ANN M. GAUMOND
Commission No. +n`' •.. ': My *ION9GG269714
iv EVIRES:DemmberT,2022
Revised
Personally Known ✓ OR Produced Identification
Type of Identification Produced
Commission No.
W COMMISSION S GG 269714
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