HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr �
1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: z)CANNED Permit Number:
BY
't Lucie County RECEIVED
Building Permit Application NOV 261019
Planning and Development Services
Building and Code Regulation Division permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 5t. Lucie CountY
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Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial L— Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line II
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
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'PUN Naz lr Ar15# cAmy Jbr&,•r, M 'zr� A ur2i r 6 zz
PropertyTax lD #: 5,S-22. 6o-7 ' Oo teO •0CYO-3 Lot No.
Site Plan Name: 4164404c.✓ Block No.
Project Name: A40 1Z"evw
Setbacks Front Back: AIA- Right Side: I' IA Left Side: N�A
DETAILED DESCRIPTION OF WORK:'
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CONSTRUCTION INFORMATION:
�Cdaffiowor to e e orme under tis permit c ec a rlappy:
❑HVAC Gas Tank Gas Piping Shutters �IX�y{� Windows/Doors
Electric ❑ Plumbing ❑Sprinklers ❑ Generator LJ Roof = Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $
OOUsap
S Ft. of First Floor: _
Utilities:cn Sewer ❑ Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name '120k22T
Name: MICHAELGOODWIN
Address: 02(/ ' *tlrn hv&--
Company: JENSEN BEACH ALUMINUM
City: CA•n-rn-1y! h lie State: 2L7
Zip Code: // % ?' Fax:
Phone No. 6����'f�r��
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 requirea.
SUPPLEMENTAL CONSTRUCTION.LIEN
_L
LAW INFORMATION:
:I
DESIGNER/ENGINEER: _ Not Applicable
Name: CZ &VA" �oS-C-e
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: {! S Gh7-6z LT
Address:
City: V State:
Zip: 39—=`fPhone: 72 _
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
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-residential use
WARNING TO OWNER: Your failjre Record a Notice of Commencement may result i yo ymg twice for
improvements to your ptop�ft oticeofCommencement must re orded a p don the jobsite
beforefirstigspecttvn. }fy tend to obtain financing, consft with a (der r orney before
commen mew k or co di ¢ur Notice of Commence
STATE OF FLO7I�PJ� f�V Y i � COUNTY OF COUNTY OF
The r instr ent was a snow d e efore me The for o' g instr .nt was ac nowl g d[b�efore me
this y of �( l) 120 aby thisday of 20 / � by
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(Name of person acknowledging) (Name of person acknowledging )
Personally Known
Type of Identification
Commission No.
Revised 07/15/2014
' State of Florida) (Signature (WNotary P lic- State of Florida )
OR Produced Identification Personally Known OR Produced Identification
iced Type of Identification Produced
public Stet' of FloddB
�0���i,,j.n _ _ Commission No. p to of Fbriae
Ange a
M C11- 07ID4,2 GG 2351D2
Y fires 07104rLD22 E) Commission 22 235102
Exp Expires 0710412022
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