HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
SCANNED Permit Number: ��lS/ (' 0 W /
BY
St. Lucie County
RECEIVED
Building Permit Application a tots
Planning and Development Services SFP -2
Building and Code Regulation Division De artrnent
2300 Virginia Avenue, Fort Pierce FL 34982 S cer tP
4 St.. Lucie County
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
PROPOSED IMPROVEMENT LOCATION-'
Address: 975-0 S Ocep',., )m pF1 - L( 9
Legal Description: IS"cr'.O ' U^l2S el�O �} U/Nr�i
A-t,p A-OM.tigmL, Cot-oo
Property Tax ID#: —OiCT —0co—q Lot No.
Site Plan Name: t.oT— Block No.
Project Name: 13
Setbacks Front r Back: N A Right Side: N Left Side: Q-
(' DETAILED DESCRIPTION OF WORK:.
CONSTRUCTION INFORMATION:
HVAC LJGas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ t oo.
Piping
Sprinklers
S''"Olrw GfrtstDvt;
Shutters tL\J Windows/Doors
Generator ❑Roof = Roof pitch
S Ft. of First Floor: _
Utilities:Cn Sewer E]Septic
Building Height:
'OWNER/LESSEE:
CONTRACTOR:
Name— L bY' }ir/k�Ot.ri
Name: MICHAEL GOODWIN
Address: 1517so S OL }���2� t (9
Company:.JENSEN BEACH ALUMINUM
City: 'FJ'-*C4 State:
Zip Code: tf R Fax:
Phone No. Z22 — 3 y 9 - �%y q�
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
It value of construction is 5Z500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION- III
ucalulvcn/ olvanvccn: _ Ivot,vppncaole MORTGAGE COMPANY: _ Not Applicable
Name: j%r.040A A/UM�NNM �71*A&0Z4AlL Name:
Address: 4;-Wo A�rNFA, 5&t,2r fbi/U Address:
City: Stater City: State:
Zip: �, ,G, Phone: / i4 Yo P� Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
_Not Applicable
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 re exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, f�es, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Yo01faVtecoda Notice of Commencement may result in ur p ying twice for
improvements to yo pr ce of Commencement must be reco dad a p s on the jobsite
before the ' ins ct' n. to obtain financing, consu it nder orney before
comma n o ecoftice of Commencement.
s
Signature of Owner/Lessee/C ntractor Agentfor 0 Signat a of Contra or/License Holder
STATE OF FLORIDA STATE OF FLORID �I n ,'/ "
COUNTY OF �{�%� /ice COUNTY OF�i d Wl` .
The for oing instr ent w s ackpowl�dged before me The for oing instru ant as ackn wledged before me
this day of �n,C4�L/. 20 4by this day of �20 by
M i (*aej (360JW 1n
(Name of person acknowledging )
(Signbttlre of otaryPublic- State df Florida)
Personally Known -- OR Produced Identification
Type of Identificati roduced
Commission No. (np,, ,; State of Fia ae
Revised 07/15/2014
)IN k -UP >S()JW (n
(Name of person acknowledging)
(Signature of(Notary Public- State df Florida )—
Personally Known OR Produced Identification
Type of Identificati Produced
No.
State of Florida
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