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Date: SCANNED Permit Number: (o-0S9
BY
St. Lucie County
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
oonio crr1 IBAbDntic KA.CKIT I rir AmnhiA - -
Address: `(Lt 00 N Nh64pAq A• 114 N 5 ,
Legal Description:
J7Pr2A'6ar� ti rT y s
Property Tax ID#: 14Z3 — fal0— CZxg-- OO-- 0
Site Plan Name: Z�4 Pr¢n/E
Project Name: � ^V �l o Cry Iftra
Setbacks Front % JP Back: Right Side: N 0_ Left Side:
L=IHVAC L_=1Gas Tank UGas
11 Electric 0 Plumbing []Spr
Total Sq. Ft of Construction:
Cost of Construction: $ 5-4 o—.>
nir— cnecxall [Fn apply:
Piping _Shutters
nklers ❑ Generator
_ S Ft. of First Floor: _
Utilities:In Sewer El Septic
Lot No.
Block No.
Windows/Doors
Roof = Roof pitch
Building Height:
.OWNER/LESSEE; -
CONTRACTOR:
Name rvaw
Name: MICHAEL GOODWIN
Address: ''tLi oc '
Company: JENSEN BEACH ALUMINUM
City: f/r 6 r�Nev' State: w
Zip Code: y 9 y C/ Fax:
Phone No. S303 ' �915
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 nextpage (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.
I' SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: III
Name: _
Address:
City:
Zip:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: _
Address:
City:_
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
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-r idential use
WARNING TO OWNER: Your fail Rec otice of Commence4beded
suit i oup twicefor
improvements o yo r pr e e of mmencement musa the jobsite
irf b gbefore the f' t ns ecti tend to tain financing, consury before
comment e w or r c n vour Noti of Commencement.
as
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5T _/ 1 COUNTY OF .ST .LUCRE
The forgo' g instrument was acknowledged before me The forgoinn instrument was acknowledged before me
thiq� S' of SU f�� ZO/�by thi,&5 `8 of 20 5by
(Name of person acknowledging j (Name of person acknowledging )
(Signaturevf Notary Public -State of Florida) (Signatur otary Public- State of Florida )
Personally Known ✓ OR Produced Identification
Type of Identification Produced
Commission No. •• t .GAUMCY)Z)
MYCAMMISSION#GG269714
Revised 07/1
Personally Known ✓ OR Produced Identification
Type of Identification Produced
Commission No.
rp. r
EXPIRES: December 7, 2022
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