HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED O
Date: A �/ SCANNED Permit Number:
�1 BY
Jr'.JT J- -- <_ St. Lucie Coiin RECEIVED
Building Permit Application AUG 0 7 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
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 II
PROPOSED IMPROVEMENT LOCATION:
Address: rrn--;c 0-nD 5 i�C�_r� Detirye
Legal Description: t a+.sn N07 gp Qg> A cr . o u PAVtf 6 C�7 C'ECT7 orJ
33- -r0WA4**7P ?b 5, 411E AI r'#i&'fV' 11V 7iec��twnn.J vt-_ oawj�
Property Tax ID #: —Ozyo- MO-0 Lot No.
Site Plan Name: f}OA4,- Block No.
Project Name: Aw/bt�,4 9-,
Setbacks Fri
Back: N Right Side: N 0' Left Side: -,rl
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION':
iWitional work to Bee orme under tispermit-checka appy:
❑HVAC 11 Gas Tank ❑Gas Piping _ Shutters -I_j Windows/Doors
❑Electric ❑ Plumbing []Sprinklers ❑ Generator Roof ❑ Roof pitch
Total Sq. Ft of Construction: Sct. of First Floor:
Cost of Construction:$ /81 oor) Utilities: nSewer ❑Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
a
Name /S Cikr.n lZirttir ��I�..r�a �'
Name: MICHAELGOODWIN
Address: 3'7- O
Company: JENSEN BEACH ALUMINUM
City: State: 2
Zip Code: 1YfI? Fax:
Phone No. 2�9 — ����
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 ei=Coltoeu Notice of Commencement is regwrea.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _
Name: Fttx4o4 Q/r ml,, fm
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: I/YO /l�lAstuw,r Siarj�/
/o
Address:
City: 72YI't)A
Zip:Phone:
State: _F=1
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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an9covenants 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 to another non-residential use
WARNING TO OWNER: Your 11 e o R rd otice of Commencem ma ' sult in o mg twice for
improvements to our o No ce o ommencement mu Breed �i� Ythe'obsite
before the first inspec o I o in nd' obtain financing, co ult wui }finder r ttorne before
Comm cI a rk o r 1 v r N ce of Commenceme
c v - v — � s
Signature of Owner/Lesse c tractor as Agent for Owner Si nature of Contrac or 1 nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgo" 9 instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ay of � z - 2q/_by thi5V&ayof_/�(%,67— 20 -% by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public -State of Florida) (Signature o otary Public -State of Florida )
Personally Known � OR Produced Identification
Type of Identification Produced
Commission No.
ANN M. GAUMOND
Al MYCOWMISSIONt
Revised 07/15/201 m• _a` EXPIRES Dacember7,2022
Personally Known t/ OR Produced Identification
Type of Identification Produced
Commission No.
ANNM.GAUMOND
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