HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �mz
1Date: SCANNE�Permit Number: ^` l J� kl—1
BY RECEWD
_ y• St Lucie Count FEB 21 1010
Building Permit Application permitting Department
Planning and Development Services . )St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ResidentidS
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LO.CxATIONI " h
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f , ...
Address: (
VA U9 1YCGU VI YIGtL-111
Legal Description: 6r(,ew
Property Tax ID #: I M — f /001 - 008 - 60D'a Lot No. S
Site Plan Name: Block No. o�
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:'
0HVAC ri Gas Tank ❑Gas Piping U Shutters
Electric Plumbing []Sprinklers Generator
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Total Sq. Ft of Construction: S Ft. of First Floor:_
Cost of Construction: $ Utilities: Sewer Septic
`l e h owe e
QWindows/Doors
Roof Roof pitch
Building Height:
f'OWNEE /LESSEE`
-!N. s.. �.l�WHair' _
.; w ., K.•. ,
TRACTORz `milk
Name 5,.
` ' ^`'
John E Murray,_
Name: y:.,.. ..,. „...,,. � .
Address: P ,_ , _
Company: AMS' INC
1
City: State:
Address: 941 SW 8tli�Sireet
Zip Code: Fax:
City: Pompano Beach State: FL
Phone No. a%o
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 fisted above)
State or County License: CCC042787
If value of construction is $2500 or more, a R, ECORDED Notice of Commencement is required.
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S,URP, �EMENT"AL C®NSTRUC3TION
LIEN jLAW INFORMATION
•.6-'V,rJ«�.,.
DESIGNER/ENGINEER: _
Not Applicable'
MORTGAGE -COMPANY: _ Not Applicable
Name: James Bushouse
I
Name: N/A
Address: 3300 NE 1OthTerrace #24
Address:
City: Pompano Beach
State: A
City: ' ' State:
Zip: 33064 Phone 954-956-2203
I
Zip: Phone:
FEE SIMPLE TITLE-HOLDER: _
Not. Applicable
BONDING COMPANY: Not Applicable
Name: N/A
I
Name: NIA
Address:
I
Address:
city:
I
City:
Zip: Phone:
Zip: Phone: I
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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 commeI�ced 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 fo obtain financing, consult with le or an attorney before
co encing work or recording our Notice of Commencement.
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001
�S!—ture Owner/ Lessee/Contr or as A t for.Owner
Signature _ _ _ 's older
STATE OF FLORIDA
I
STATE OF FLORIDA
COUNTY OF��'f". 4 (.FC I-r—
COUNTY OF aroward
I
The forgoing instrumept,was acknowledged before me
The for�oing instrume t w acknowledged before me
15?
this � day of �J Gt �v� , 20� by
this I) day of 20by
Mc co li
John E Murray
N me of person making statlement
Namwof person making statement
Personally Known OR Produced Identificlation
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced L-
Produced
i
(Signature of N ary Public- State of Flo ' a) I
(Signature of NoJ4ry Public- State of Floidda )
�:.��% MARYANN PAGE
Commissi MY COMMISSIONiFF22758XSea1) I
a0 !! �';B�% MARYAN PAGG
Commission No. COMMISSI P L7587
EXPIRES: May 5, 2019
N'�rFOFF�oa�O!
EXPIRES: May 5, 2019
BondedThruBudgetNotary Services I
OFFBonded ThruBudget Notary Services
REVIEWS
FRONT
ZONING
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SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
//$
COMPLETED
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Rev. 8/2/17