HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: % \� SC
Permit Number. d5-<31
BNrNED
ECEIVED
St. Lucie County
0
Y 31 2019
Building Permit Application
LST-Lucie
Planning and Development Services Count Y, Permltting
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-77
C Once
PROPOSED TMPROVEME_NT LOCAL
Address: q HOo S O Q71roJ 7�W_ 704 TFwC a
Legal Description:
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Property Tax ID #: ?iSrf;�— 'M 7d2- 00s-0 - Ooo - z Lot No.
Site Plan Name: F�aor, 4'IK/i'Z_ Block No.
Project Name: IC40 G I i'M G-,L—
Setbacks Front Nip- Back: /-,+ Right Side: N 4 Left Side:
DETAILED DESCRIPTION OF WORK
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;CONSTR T-1, -,INFORMATION:. `x �, • ry
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Additional work to e performed urider t ispermit-check all Th at appy:
E1HVAC GasTank ❑Gas 0Shutters
Piping
jWindows/Doors
11 Electric 0 Plumbing ❑Sprinklers D Generator L=1 Roof Roof pitch
Total Sq. Ft of Construction: Sq �Ft. of First Floor:
Cost of Construction: $ Lt ro0 Utilities: LJ Sewer 05eptic Building Height:
_OWNER/LESSEEK .`
..Name
CONTRACTOR:
LO r��dL/'
I_'74kA-}M�_IlI o c pwpNA
Name: MICHAEL GOODWIN
Address:
Company: JENSEN BEACH ALUMINUM
City: L AtG ryN State:
Address: 1720 NW FEDERAL HWY
Zip Code: r&2 r1 Fax:
City: STUART State: FL
Phone No. / 75766 d 1 g - 32(ld
—�—
Zip Code: 34994 Fax: 692-9744
E-Mail:
Phone No. 692-0090
Fill in fee simple Title Holder on nextpage (if different
E-Mail: MICHAELLGOODWIN@YAHOO.COM
from the Owner listed above)
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:
Name: GLD.2/Oo*
—Not Appli able
n/ 11
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
-Af/o
Address:
City: /I4
Zip: —?,,O Phone:
State:�i_
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
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 additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure t Record a Notice of Commencement m result' ur paying twice for
improvements to your propert . tjce of Commencement must be r ded posted on the jobsite
before the first in ect'on. end to obtain financing, consult ' h d an attorney before
commencing w r o c ur Notice of Commencement.
s
Signature of Owner/Les a/Contractor as Agent for Owner Signature of Contra e o License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF i COUNTY OF ST
The for of instrument was acknowledged before me The forgoing instrument was acknowledged before me
thig� wof Z:ZI {/ 20/pby this.. eof Z2fw 201,9 by
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(Name of person acknowledging) (Name of person. acknowledging)
(Signs of Notary Public- State of Florida) (Signature otary Public- State of Florida )
Personally Known;L OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.
Revised
Commission No.
ANN M. GALIMOND
EXPIRES: December 7, 2022
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