HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: SCANNED Permit Number:p_ -( C"5
BY
St. Lucie County
� - RECEIVED
Planning and Development Services Building Permit Application /'e� MAY271919
ttin
de Regulation Division
2300Virginia Ang and venue, venue, Fort Pierce FL 34982 t' Build1Lu eC0(,nty ent
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow ai the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: rtba 5 pLEAN (Da f-(ooy
Legal Description: -rho P2 Nw;S or -
Property Tax ID #: 9`5_62- 6fQ -ono s9 -cry-Y
Site Plan Name: RVOS le'*,yy t'
Project Name: F(io( 14or, IGA
Setbacks Front N Back: T Right Side: Left Si*: ___Af
Lot No.
Block No.
DETAILED'DESCRIPTIONOFWORK:
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S o�lEn/Ini�
i Z �- Ry—�watec•°Hi�
� 3 wl� Exra•�7/N6
SHv�-TtT
-,CONSTRUCTION INFORMATION;
Additional wor to e e orme under t-Checkispermit
E1HVAC 11GasTank []Gas Piping
a that apply:
Shutters
0
Windows/Doors
11 Electric
El
Plumbing
Sprinklers
I
Generator
Roof
=
Roof pitch
Total Sq. Ft of Constructio
Cost of Construction: $ I611 000 —
5 Ft. of First Floor:
Utilities: Sewer 11 Septic
Building Height:
OWNER/LESSEE: "
GOI'JTRACTOF;:
Name f L05 e-Olykllo- } rl'"Iyl= iC rVAtJY,
Name: MICHAEL GOODWIN
Address:: 'T&(-b 5 t X;ay/ DID ''(.05
Company: JENSEN BEACH ALUMINUM
City: State: _R-
Zip Code: &S('7 Fax:
Phone No. -7?tt = I CGS
Address: 1720 NVv 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: MICHAEL.L000DWIN@YAHOO.COM
State or County License: CGC 1508437
Itvalue of construction is 52500 or more, a RECORDED Notice of Commencement is : squired.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION":;^
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: F6u/unQ' 4t."MINVPI Q✓bWeVA115 Name:
Address: sylMo /4ir►trdrt2 Sure% rio Address: _
City: State: M City: State:
Zip: S74yj Phone: /? 37y,01'03 Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable
Name:
Address:
City: _
Zip:
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? estrictions 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, failu e t Record a Notice of Commencement may resent in r eying twice for
improvements to your proVrtA otce of Commencement n ust b e 0rded an os don the jobsite
before the first insp cti . 'ntend toobtain financing, consul itl lencie n torney before
comme work r oour Notice of Commencement.
Sig as
tur of Owner/Less ontraMor as Agent for Owner Signature of Con mnse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF -!9
The forgoi g instrument was acknowledged before me The forgoin instrument was acknowledged before me
thi�7 Xyof 6T- 26/2—by thisc?Q of_ 20�2_by
(Name of person acknowledging) (Name of person acknowledging ).
(Signatu'rre-of Notary Public- State of Florida ) (Signatur< otary Pubic- State of Florida )
Personally Known ✓ OR Produced Identification I Personally Known _✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. �•^ Commission No. (Seal)
{ ......ANN M. GAUMOND
uVCQMMfflI0N#GG26974
g EXPIRES:tleawW7,2022 --- 0.,: MYCOMMISSGAUMON269714
Revised 07/15/2014 '' :y�"` BwedT mNawiwb6eondwAm �;
$': IXPIRES: December 7, 2022
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEG=IATION
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS
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