HomeMy WebLinkAboutBuilding Permit Application r !
ALL APPLICABLE INFO/MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3' /• !7 Permit Number:- -7 " vc2to
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RECEIVED
Building Permit Application MAR •/ g 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
PERMIT APPLICATION FOR: To Select from dro box, click arrow at the end of line AL.v4v�kN-rN Mtr
PROPOSED IMPROVEMENT LOCATION:
Address: ti�S r--L.C-S 13Lvp 3����,� c3ef=)Ct L ?
Legal Description: NE-r-rc�s Esc-r�r� lcv� co,l3�a- S �-rcorJ ll 6'A�LE�_ F�Q AN.D
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Property Tax ID#: So k acvo- '�L_ Lot No.�� _
Site Plan Name: B1ock.No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be nertormed under t is permit-check a apply:
E1HVAC Gas Tank Gas Piping rn Shutters a Windows/Doors
Electric Plumbing Sprinklers E Generator ® Roof I Roof pitch
Total Sq. Ft of Construction: coca S . Ft.of First Floor:
Cost of Construction:$ S loo . Utilities:nSewer 0 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name V'ati 0 C�F GL-U pp Name: John E.Murray
Address: Company: 'AMS Inc. ..'
City: fl'_)o State: M Address: 941 SW 8'Street ;
Zip Code: 1:�S Fax: City: Pompano Beach State:FI.
Phone No. 3SS a•3�3 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.
1
-`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 with I der or an attorney before
commencing work or recording our Notice of Commencement.
I�l�2i s
Signature of Owner/Lessee/Contract r as Agent for Owner ' a re of Contt or/License Holder
STATE OF FLORIDA STATE OF FL'ORIDA
COUNTY OF ST. LVG 1'F^ COUNTY ,F 53rLow Aslx�)
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this-7 day of rv-,A rLc—"— 20)_�_ by this '2-day of 20 L'�_by
\/'ONN\V EGL-0C�PFs� 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 _OR Produced Identification Personally Known�_OR Produced Identification
Type of Identification Produced Type of Identification Produced
e°MAY p"' ALAN MILLER �°�.."..�'C, ALAN MIL,!�E� I
Commission No. (S'0I�OMMISSION#FF 195499 Commission No. OMMISSIONVt 4499
sr a'
EXPIRES:May 5,2019 0, EXPIRES:May 5,2019
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS .�
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