HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE IN F MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I(J Z� -I SCANNED Permit Number:
BY
St. Lucie Countv
Building Permit Application
Planning and Development Services
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 III
®7:tiT• t�i19:iHod ii "iIM"Ll III
Address: Ll ut tap M 4wot u A 14 35 I Fi 19,e-ar-4C-
Legal Description:
?A-r2A6PQN UN IT 37 (OR Nf03- 10s(6)
Property Tax ID#: ILtZ.?-(a10-c:)o03- 000-(. Lot No.
Site Plan Name:
Project Name:
Setbacks FronttJ Ih- Back: N A- Right Side:— Left Side: !}
DETAILED"DESCRIPTION OF WORK:;;
Block No.
AaaaionalworKtoDe errormea
1]HVAC Gas Tank
unaertmspermit- cnecKau
Gas Piping
apply:
_ Shutters
Q Windows/Doors
Electric El Plumbing
®Sprinklers
Generator
Roof Roof pitch
Total Sq. Ft of Construction:
ScFtFt.I of First Floor:
Cost of Construction: $ S'L/C7c.�-
, 00 Utilities:
Sewer Eheptic
Building Height:
OW NE_ R/LESSEE:
CONTRACTOR:
Name
IFS
Name: MICHAEL GOODWIN
Address: LH
W
AA N
company: JENSENBEACH ALUMINUM
City: C-ff Or -e.Z7
Zip Code: Fax:
Phone No.
State: PL_
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:
Name: YnoYLcna umlyaM�
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
//o
Address:
City:
Zip: 2 honer,
Stater
g
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 gre exempt from undergoing a full concurrency review: roomKresnid
s,
accessory structures, swimming pools, es, ails, signs, screen rooms and accessory uses to an heential use
WARNING TO OWNER: our a' a Record a Notice of Commencement y res ing twice for
improveme o our ro r y A otice of Commencement must b o e sted on the jobsite
before th irst i pe o y u "tend to obtain financing, consult i n r attorney before
comme ing o g our Notice of Commencement.
s
Sign ture Owner/Less Contractor as Agent for Owner Signature of Contractor ' nse Holder
STATE OF FLORIDA OF FLORIDA
COUNTY OF STiLIJC/F COUNTYOF _S77Z4x^JE
The forgo' g instrument was acknowledged before me The forgoing instrument was acknowledged before me
they of \3_4)PEE 20/-9—'by th r�3y of �lJ0� 20 / % by
(Name of person acknowledging) (Name of person acknowledging )
(Signatur f Notary Public- State of Florida) (Signature o otary Public- State of Florida )
Personally Known �" OR Produced Identification Personally Known / OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.
Revised
EXPIRES: December 7, 2022
Commission No.
ANNM.GAUMOND
EXPIRES: December 7,2022
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