HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE,COMPLETED FOR APPLICATION TO BE ACCEPTED ,,,-e-,
Date: d 1 �1 Permit Number:»
Building Permit ApplicaiftECEIVE®
Planning and Development Services
Building and Code Regulation Division OCT 3 U 2017
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial gj nt
PERMIT APPLICATION FOR: To Select from dropbox, click arro U I 011nty,
`PROPOSED IMPROVEMENT, LOCATION:
Address: 4-0a3 W o S7 C-r : P 3I.A(�t�.k�
Legal Description: V-!i P rsLc,.i b Lce—g , Co - o+? LgCt
L02 3--7-0.7 �30
Property Tax ID #: ocoo( Lot No. )LZ-2S
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED:DESCRIPTION OF WORK:
.11 CONSTRUCTION INFORMATION:
Additional work to e e orme under this permit - c ec a apply:
11HVAC Ei Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
Electric F]Plumbing Sprinklers 11 Generator E] Roof Roof pitch
Total Sq. Ft of Construction: ora c:;, S . Ft. of First Floor:
Cost of Construction: $ �\ c�-�. o o Utilities:�Sewer Septic Building Height:
_VOWNE-R/LESSEE:
CONTRACTOR: r
Name E��� 5c�rc�
hn-
Name: Jo,E; Murray
Address: S-i , L.ir_if_:, C1 'a')S
Company;,
City: _, -- Psic�.. State:'�:IL_
Address: 941 SW 8 Street -
City: Pompano BeachZipCode: State:FI.
`
Phone No. &\'-\ -
Zip Code: 33069 Fax: 954-782-0995
Phone No. 800-226-6677
E-Mail:
'E-Mail: maryannp@amsofFla.com
Fill in fee simple Title Holder on next page ( if,different
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.
�iSUPPLEMENT. L CONSTRUCTLON LIEN LAIN INF.ORMATION'`
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: •Not Applicable
Name: JamesBushouse Name:
Address:.1550,NAndrewsAve_„-,�,,-_.__, ,_,;,,_..,-._._....••I Address:
City: IPornpano.Beach; ,. ,� z c>w i !'i'fs rsr-, r`"" State: Fi. City: State:
b,
Zip 33069^ 1�} Pllone 9549562203>: Zip: Phone:
FEE SIMPLE TITLE HOLDER: ., ,Not Applicable BONDING COMPANY: Not Applicable
Name:„ t. Name:
Address: 1 Address:
City: ' ; e I :,; f, ,..I t ;:s `_';1..s i ; , ;1.: J' i , 1 _:S 1 City:
Zip: i i", .,-qr, Phone: al g 7 1 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 ei empt 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
commer}c1inR wprk dr repbrding vour Notice of Commencement.
STATE OF FLORIDA
COUNTY OF -S-r.
The forgoing instrument was acknowledged before me
this -Lq day of 20 1 % i
(Name of person acknowledging)
(Signature pYNotpKy Public- State of fhrtchi)
U
`�aanum,,,ngiiii
Personally Known RY� duced Ident
Type of Identification TIMOTHY
Of
mission No. yd3:" P'a MY
Revised 07/15/2014
CT
STATE OF FLOR1,6A
COUNTY OF / SLve-t
The forgoing instrument was acknowledged before me
this i L-k day of 20 A:�) by
John E. Murray
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known �^ OR Produced Identification
Type of Identification Produced
Commission..No.FF\-LS'k'k`� (Seal) -
���; ••• .�% ALAN MILLER
W COMMISSION 8 FF 195499
EXPIRES: May 5, 2019
Nr°re,uwe Bonded Thru Budget Notary Services
REVIEWS
FRONT
ZONING
I
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS