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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �c22. 1 /-ST Permit Number: RECEIVE® o x Building Permit Application FEB 2 7 2017 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 X PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line M H-cZ ov-- PROPOSED IMPROVEMENT LOCATION: Address: '.1© 1 �U2�DrJ k GG= Legal Description: �3"3 -'3y-Leo SF-`(L-k OF OW L.-Ic, EOF- gL, CLIW G-I-t�S�01�C r Ca V �C X t�.►p rQ S c) -r vA W A r l" (a.N Cs SS 1 b a Property Tax ID#: -:;)AC) Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED'DESCRIPTION,OF WORK: ry SrrCA-L._ O 6 A v 6r :z O L-1LtZa P-J J N\i V v N <D C)T 6-v' f� 'D rJ -C;* M N\,C CONSTRUCTION INFORMATION: Additional work to be ertormed under this permit-cleck all apply: EIHVAC Gas Tnk Gas Piping Shutters E]Windows/Doors Electric 0 Plumbing Sprinklers Generator ® Roof 1 Roof pitch Total Sq. Ft of Construction: Sli of First Floor: Cost of Construction:$ f7 �. okr Utilities Sewer Septic Building Height: ;OWNER/LESSEE: CONTRACTOR: Name,:: Name; 49hn;E.,Munray Address: 'a D\, (h,'v:rL.e,r-4 C_�XL_ Company: AMS,Inc. City: , �a �� State:1_ Address: 94,1 SW 8 Streefi Zip Code: Fax: City: Pompano Beach State:FI. Phone No. 7"7 a--Lk 66 -3'707(o Zip Code: 33069 Fax: 954-782-0995 E-Mail: Phone No. 800-226-6677 Fill in fee simple Title Holder on next page(if different E-Mail: maryannp@amsoffla.com from the Owner listed above) State or County License: CC C042787 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:; DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: JamesBushouse Name: Address:1550 N Andrews Ave Address: City: Pompano Beach State: FL City: State: Zip: 33069 Phone: 954-956-2203 Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: \.� d— �Ft��-� F sue_ Name: Address: '3 tv{ 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 failure to Record a Notice of Commencement may result in your paying twice for improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencemen Z�,Zx s Signature of Owner/Lessee/Contractor a gent for Owner of C ctor/License Holder STATE OF FLORIDA STATE OF ORIDA COUNTY OF S'C'• LJ L\T COUNTY F Sao W-c� The forgoing instrument was acknowledged before me The for oing instrument was acknowledged before me this�day of 20 Eby this \day of r-Gcz-1 Arzy 20 by John E.Murray (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known 4, OR Produced Identification Personally Known rj�, OR Produced Identification Type of Identification Produced '" Type of Identification Produced ALAN MILLER � ALAN MILLER ro; Pilot,•••., � ;•••.� � Commission No. _LSg�AOMMISSION#FF195499 Commission No. a l)�M1Y COMMISSION 1kFF1954 EXPIRES:May 5,2019 v EXPIRES:May 5,2019 '1rF o�� Bonded Thru Budget Notary Services °rF�FLOP�� Bonded Thru Budget Notary Sery Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE ., COMPLETE �A, A INITIALS