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HomeMy WebLinkAboutBuilding Permit Application AdL ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED //��I Date: Permit.Number: �cz, ' n/3-Lp Building Permit Application FEB 01 6w Planning and Development Services Building and Code Regulation Division PLiirv117TING 2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucia County,FL Phone: (772)462-1553 Fax:!(772)462-1578 Commercial Residential i PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line M 4 rr PROPOSED IMPROVEMENT LOCATION: Address: \3�ba.7 S� s7t�rJ zs �ETTZ s�Z '` +--la SC ,S�c.� 3c t-r F 3K9S� Legal Description: L-4V-'F-- MANr_>9_ PAgAt C ncpPF�A"t��! o c'L I Property Tax lD#: LASoS) - SOS - Q1Q14C>- bay - Lot No. O Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: N S"; 1.-►_ .t7�z �q•�6 �2� yl-�s"�� A Z rv� N v+� C-Z-0 0 r o v GZ p,J rn a3t� H4 nn•� Arv.l� F't_o n��H- rZ o a� I CONSTRUCTION INFORMATION: Additional work to be nerformed under-this permit-check all apply: _ 11HVAC Gas Tank Gas Piping —Shutters Q Windows/Doors Electric Plumbing Sprinklers —Generator © Roof a t Roof pitch Total Sq. Ft of Construction: _` (�c�d7 5� S . Ft.of First Floor: 1�o Cost of Construction:$ S .max, Utilities: Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name_ Name: John E.Murray Address: L-\3 PjsgN=r-..C��c = Z Company: AMS Inc: City: State:N C— Address: 941 SW 8 Street ;I. Zip Code: 1Fax: City: Pompano Beach State:FI. Phone No. 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 I � 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: FI. City: State: Zip: 33069 Phone: 954-956-2203 Zip: Phone: FEE SIMPLE TITLE HOLDER: -,Not Applicable BONDING COMPANY: Not Applicable Name: 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 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 h lender or an attorney before commencing work or recording our Notice of Commencement s Signature of Owner/Less ontractor ds Agent for Owner ure o Contractor/License Holder STATE OF FLORIDA STATE O FLORIDA COUNTYOF COUNTY OF C3rz—`-J1=� The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this At�day of--% 2012by this>Ao day ofaON-r-n^/ 20 by Me4rVi__17�' Ll<aJ b <-LR-N V\1 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 -)I, OR Produced Identification Personally Known��OR Produced Identification Type of Identification Produced Type of Identification Produced 1�nr rse iF ; P,•�% ALAN MILLER ALAN MILLER MY COMMISSION 8 FF 19549 Seal Commission No, MY COMMISSION#FF9KAEp Commission} 2019 195 ) EXPIRES:May 5,2019 1 Sy �1 �o< EXPIRES:May 5, rE F�� BondedThruBudgelNotaryServkd Bonded ThN Budget Note Servkoa � Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE .� `�j 11 COMPLETE A l r INITIALS