HomeMy WebLinkAboutBUILDING PERMIT APPLICATION,
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED `�j �n Q
Date: Permit Number: 1 1 i z,
BY 10
_ __ �_ _•__ _ __-___ ___ St Lucie Cou rt
Building Permit Application DEC 2 g 2017
Planning and Development Services
Building and Code Regulation Division PERMITTIfNGSt. Lucie County, 2300 Virginia Avenue, Fort Pierce FL 34982 FL
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��`���"V�'�
iPROPOSED IMPRROVEMENT,LOCATION:
Address: lS 4) H TL-y F__ w ai:j RD <IT 5:�T-. L_0 Lt f-. V-L-� _ 3'-�•9�
Legal Description:-&T. Lv4--tr- r.,i}rlorwys 36 yo apus A,4-IN L"'IG EJL--K QS 1z �L_
CL\w i-F_ Ss (LC) RS I W I 0-) C C-AVFS 2 " yi�P
Property Tax ID #: 2'LA\'-\ - l-to Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAI:LEDDESCRIPTLO,N OF WORK:
► �►_ f1►J i-vrnN. jJv\� maco o" �
,CO.NSTRUCTION INFORMATION:
Add'itionalworKtonenertormedunder this permit- check
0
all
In
apply:
a
0HVAC
Gas Tank
❑Gas Piping
_
Shutters
Windows/Doors
11 Electric 0 Plumbing
[]SprinklersE
Generator
Z. Roof Roof pitch
Total Sq. Ft of Construction: Lk00
S . Ft. of First Floor: l�cao
Cost of Construction: $ �1 oa. C;V Utilities.
Sewer
—
Septic
Building Height: l o
OWNER/LESSEE: 7 :
CONTRACTOR .
Name _0-00N£>( i52oL1 DvS
Name: John E. Murray
Address: IS Cry
Company: AMS Inc.,
City: 002-s-s-r=• i._ )C k,; State: FL_-
Address:'941:SW 8th.Street.
Zip Code: 3i-\�S� Fax:
City: Pompano'Beach State: Fl
Phone No. r7-12;7-2 3\ uS
Zip Code: 33069 Fax: 954-782-0995
E-Mail: N \ A "
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 5Z500 or more, a RECORDED Notice of Commencement is requirea.
SUPPLEMENTAL.CQNSTR,UCTIO.N iLIE-N-,LAW1
INFORMATION; ,.
DESIGNER/ENGINEER: I _ Not Applicable
MORTGAGE COMPANY:
-A Not Applicable
Name: James Bushouse
Name:
Address: 3300 NE 10th Terrace I
Address:
City: Pompano Beach I State: Ft
City:
State:
Zip: 33064 Phone: 954-956-2203
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY:
Applicable
Name: WJ -toNF_ l3v«C��,�Nb corn-P
Name:
,Not
Address: A.11F_
Address:
City: qv\
City:
Zip: Phone:
"
Zip: fin_ Phone: I
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. Al Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult wi h lender or an attorney before
commencine work or recording vo6 r Notice of Commencement. �
STATE OF FLORIDA
COUNTY OF 9T. L_".)
The forgoing instrument was acknowledged before me
this IV day of C'ECE rrNGCR_, 20 Eby
2o0(10>~=—( 13r1C'C--v
(Name of person acknowledging) .
(Signature of Notary Public- State of Florida )
Personally Known &-A, OR Produced
Type of Identification Produced
Commission No.
Revised 07/15/2014
Holder
STATE OF FLORI[
COUNTY OF Br—,d
The forgoing instrument was acknowledged before me
this day of 20 12_ by
John E. Murray
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
ation Personally Known_ OR Produced Identification
..Type.of Identification Produced
ALAN MILLER°S;aY P°eV'o ALAN MILLER
MMISSION # FF 195499 Commission No. * SVQ COMMISSION # FF 1954
IRES: May 5, 2019 s, EXPIRES: May 5, 2019
'hru Budaet Nnlary Rervires 4 «, oQ`O Bonded Thru Budoel Wary Sani
(SUPERVISOR
REVIEWS
FRONT
ZONING
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
I REVIEW
REV"
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
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