HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
�� SCANNED Permit Number:
Date:
BY RECEIVED
St. Lucie County
- JUL 2 4 2019
Building Permit Application
Planning and Development Services 5Y, hW418 GOFffltgl HFfi'H11EBIfly
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
PROPOSED IMPROVEMENT LOCATION.:.') „�; `,, "_h, js it J 'fIi I I i 111 li�' ' r, "
Address: -7?70 S D 69Ari I22 t (ol s Tb.,f� 1 '7 -8c tt
Legal Description:
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Property Tax ID #: U-0-1A O:� mige-) - nny -2 Lot No.
Site Plan Name: �!� Ja N-J t< Block No.
Project Name: J^'w' L/
Setbacks Front N a Back: iLkA Right Side: N Left Side: N O
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'DETAILED�DESCRIPTIOM'OF.WOE2K a Is"�i`r'
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CONSTRUCTION INFORMATION._,
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Additionalwar to je ulluilliad un ert ispermd-c ec Oil apply:
,Windows/Doors
[JHVAC L Gas Tank ❑Gas Piping _ Shutters
❑ElectricPlumbing OSprinklers []GeneratorRoof Roof pitch
Total Sq. Ft of Construction: Sq• Ft of First Floor:
Cost of Construction: $ �� 000 Utilities: In Sewer Septic Building Height:
^OWNER/LESSEE:
Name a E a
Name: MICHAEL GOODWIN
3ENSEN BEACH ALUMINUM
Address: 12'/ n S Dca% .J �/L (5
Company:
Address: 1720 NW FEDERAL HWY
�'a l*i i KL� State: �j�
City:
�`_'_`�—
Zip Code: 3cfgff:1 Fax:
City: STUART State: FL
Phone No.
Zip Lode: 34994 Fax: 692-9744
E-Mail:
Phone No. 692-0090
Fill in fee simple Title Holder on next page (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.
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SUPPLtIVItNIAL tJIVJfttW�l.lvrv,glcrvivyuy))vj�;r) tip°!�'1..I 1 t;l+ie.,,.1•.� >
DESIGNER/ENGI EER: _ Not Applicable �1/ MORTGAGE COMPANY: _ Not Applicable
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Name: FLtOA Alumllv �f W,(�./A/b AName:
Address: Address:
City: State: City: State:
Zip: Phone: N - Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip:
one:
Name: _
Address:
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
strutctture. Pleafsle consult wlthpyolur Home Owners Association land review your deed for any restrictions which maor
alprohibit such
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 dditions,
accessory structures, swimming poo , fe es, w Ils, signs, screen rooms and accessory uses to ano a no -residential use
WARNIN O O NER: Y ur ailu a ec rd a Notice of Commence y resul i yo paying twice for
improv ^ e 0 our p e i of Commencement t be orded d ted on the jobsite
befor he firs i sgec If n to obtain financing, c sult I nd r ttorney before
e rVl r r r r tice of Commence nt.
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 9T I UClE COUNTY OF .9
The forg 1�g instrument was acknowledged before me The forgoing instrument was acknowledged before me
thiS�3 da'yof-J—(>LV by thiV_� P of T�V .20/L.by
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(Name of person acknowledging) (Name of person acknowledging )
(Signat(SignattureNotary Public- State of Flora ) (Signature ofN-otary Public- State of Florida )
Personally Known V OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal)
Commission No. (Seal)
W. + ANN M. GAUMON v r "" qNN M. GAUMOND
k1YCOMMISSION#GG269714 €.e i:? MY COMMISSION#GG269714
Revised07/LS/20 ram' EXPIRES: December7,2022 a �• o= EXPIRES: December
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SUPERVISOR PLANS
VEGETATION
SEA TURTLE
MANGROVE
REVIEWS
FRONT
ZONING
COUNTER
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS