HomeMy WebLinkAboutLarry Murray 7868 Carlton Rd Permit Application and SketchAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
9�6 L�UL ry
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: Ntw mt�a W
Address: t4 _�QX 1-�0Q Qd , QAA 5�. U)(Af' N(181
Property Tax ID #: �}��.$ �l "c)%e�J " ow - -L Lot ,No. _3
Site Plan Name: Block No.
Project Name: -1
New Electrical Meter '/ Second Electrical Meter
(Affidavit required)
Additional work to be performed under this permit- check all that apply:
/Mechanical
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
_ Gas Piping
_ Sprinklers
_ Shutters
_ Generator
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
Roof Pitch
Cost of Construction: $ p i 0C)b !Q Utilities: —Sewer _Septic Building Height:
NameJJ
Address:
City: S} . w6x State: P1
Zip Co %V Fax: --
Phone No. �`1i• lit+• E-
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: _ r-I\f,.Y1 Pr"Y — r
Company: L .\/�t�ENCCPA L 0�- cS •
Address: 69\0 (—"rQ SY0adS
City: State:
Zip Code: Fax-M.- COY1A - b133
Phone No_11-L- 6'13 - ?!13Q
E-Mail V
State or County License C ooqgse-
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attornev before commencine work or recordine vour Notice of Commencement.
Signature of Contractor - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF Sk .l_UG G—
Sw (or affi a }and subs ribed b f e me of Physical Presence or Online Notarization
thW day of 2by
Name of person making statement.
Personally Known OR Produced Identification
Type of 1 tification Produced
(Signature of Not ublic- State of Florida)
���"$ Notary Public state of Florida
Commission No.J_--- (Seal)
Amy Lynn Alexander
My Commission
NH 185038
Exp.10/11/2025
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REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev lu/12/21