HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONM
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� y� _
Date: 6 ZH �S SCABNrNED Permit Number: coI •q
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 Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I
PROPOSED IMPROVEMENT LOCATION:
Address: 19 -S O S 6 C4,1*ri D2 th, %Out f Tayapu � F/
Legal Description:
t S l-A"r�DiR aa..,00 70`t 7 Ott
Property Tax ID#: yrDZ- GOi-oary- 400-4 Lot No.
Site Plan Name: M' "- e�+- Block No.
Project Name:
Setbacks Front N 0, Back: N I a _ Right Side: kJ A- Left Side: N' A
DETAILED DESCRIPTION O.F WORK: r "I
IV AAVOo
CONSTRUCTION' INFORMATION;
Additional work to e nertormed under tispermit-check all that apply:
❑HVAC Gas Tank ❑Gas Piping _ Shutters Windows/Doors
❑ Electric ❑ Plumbing []Sprinklers ❑ Generator ❑ Roof ❑ Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ %2bi 00 �
S Ft. of First Floor: _
Utilities:cnSewer ❑Septic
Building Height:
OWN' R/LESSEE:"
CONTRACTOR:..
Name Itn iucELr- %n ywi E r- 647t4
Name: MICHAEL GOODWIN
Addresswj 1cwo' & 91!5 1A
Company: JENSEN BEACH ALUMINUM
City: T azo e State: J
Zip Code: 1 1 7q V Fax:
Phone No. (oil - �a:l v _y-7
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: 1:71coUon A-WmtNUIyI
Not Applicable
0JWA(b�/
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: TLI4 v 44A
fwag-n- 'to
Address:
City: 7~-A
Zip: 3?feol Phone: �Bt?
State: F4—
37y- o2w5
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- esidential use
WARNING TO OWNER: Your failur t ord a Noti of Commencement may result in paying twice for
improvements to your property A e of Co ncement must be record a osted on the jobsite
before the firs spection.,If y/ u�' d to o aiq Inancing, consult w}'tIer n attorney before
commencinao Worhec�rdifi Noti of G4mmencement. // // 'r
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgo? .Dinstrument was acknowledged before me The forgoin instrument was acknowledged before me
th�7,� of .TUor 20/ by tF �S of �(��� 20 / by
(Name of person acknowledging) (Name of person acknowledging)
(Signs re of Notary Public- State of Florida) (Signatbmof Notary Public- State of Florida )
Personally Known /,"_ OR Produced Identification Personally Known _,-' OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. 1`;eali _ _ _ _ I Commission No.
ANN M. GAUMOND i � �[ , : .,.,- ANN M. GAUMOND
2022
Revised 07/
EXPIRES. December 7, 2022
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