HomeMy WebLinkAboutBUILDING PERMIT APPLICATION1' 9
ALL APPLICABLE INFO M ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 087 p
Date: iL l l �. SCAM,,, Permit Numb r:
g
KrXciVED
St Lucie Cou tv JUN 18 2819
Building Permit �►pplication
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: f1foo j' Otoykj -Dn /002
Legal Description: OCEIrni T64,1-. 8.0vnp h? UMT /oat 47VIO �/NOi✓SY}sIYGE�
Property Tax ID #: -tQZ_o � 3 -- % `Ja . 0 U % .DUD
Site Plan Name:
Project Name:
Setbacks Front /(A Back: AJ 4- Right Side: A-14L Left Side:- N/4-
Lot No.
Block No.
'CONSTRUCTION,jNFORIVIATION:"� ._, �„ , , �'; ;
NuullrVnErwurKwue
DHVAC
enunneu
Gas Tank
unuerunspermit— cnecKau
❑Gas Piping
n apply:
_Shutters
11 Electric
0
Plumbing
Sprinklers
0 Generator
Total Sq. Ft of Cohstruction:
Cost of Construction: $ c2/DO
S Ft. of First Floor: _
Utilities:"nSewer DSeptic
&Nlindows/Doors
0 Roof = Roof pitch
Building Height:
-.OWNER/LESSEE:
_ - , • . ' u. .:"-,
;CONTRACTOR: " rt
Name
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Name: MICHAEL GOODWIN
Address: `/u/
y4*A� D/L
Company: JENSEN BEACH ALUMINUM
City:
Zip Code: 971
Phone No.
State:
Fax:
Sr-Zg
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
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: P"444* Al2unc^jtt tAAy✓HyLI
_
Name:
Address:�yL/y M AyLn.CJ 57he-r—� o
Address:
City: State: g�
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
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 fail re t r a Notice of Commencement r ult in twicefor
improvements to your prope e f Comme ent must be cor ed and the jobsite
Wyour'g
before the firstection. 1 0 o obtai nan ng, consult ith I r or before
commencin ork eco n otce of omme cement.
s
natur o Contractor se Holder
Signatureo wner/Less Contr toras'Agentfor w
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF —5 ld2CI
/
COUNTY OF S2-
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this/ y of 20%9by
th/��ay of % !J/l�� 20 /_9 by
zf Cif ��D%le�/
(Name of person acknowledging
(Name of person acknowledging )
(Signature o Notary Public- State of Florida)
(Signature f Notary Public- State 6T-FTo"nda )
Personally Known ✓ OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification Produced
Type of Identification Produced
Commission No. (Seal)
Commission No. Seal
.:i%"+.•....,, ANN M. GAUMOND
:'1s'"ti@�„ ANN M. GAUMOND
MYOOMMISSIONUGG28S714
Revised 07/15/20 :? EXPIRES: Detember7, z022
EXPIRES: Decembet7,2022
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