HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO, BE ACCEPTED Q r�
Date: %CWNNE Permit Number: ' 0�0+�- 054S
�.� By
at Lucie County, RECEIVED
Building Permit Application `FEB 9`1 2018
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 _Fax: (772) 462-1578 Commercial, Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Jr -'•:ter Y`J' M'_�KAf I 3 'e 8 ^'s p`
PROPOSED IMPROVEMENT,LOCATION
Address: So 3g , I I' 1 V LA
Legal Description: C r(_f_r,1 iT c a's
i
Property Tax ID #: 36` - oo D o Lot No.
Site Plan Name: 16111 J 1 Block No. _
Project Name:
Setbacks Front Back: Right Side: Left Side:
.-. .. _ ._ +r .i' 4,M1f ��. `��{ C?T `C l•. ''; '..i':' '...� i'lt :-'mod S �i, A��*1 'Y,d�i�.
DETAILEDrDESCRIPTION OF WORK
r�sfi�-I ( Gt✓l u w►t L r� row-�-vvev- o n .
n�ob►��hon,�
❑HVAC ❑ Gas Tank ❑Gas
❑Electric ❑ Plumbing ❑Spr
Total Sq. Ft of Construction:
Cost of Construction: $
Shutters Q Windows/Doors
Generator Roof Roof pitch
'of First Floor:
Sewer ❑Septic `Building Height:
OWNER �LESS,EExa..r; _.:ay<. ""•!
�CONTRi4CTOR
Name e ' I i�ir ,-:.:%}�:
Name: John E Murray. - :. ,. •' 'r
Address: Jf J?O �✓�ii
Company: AMS INC i
City: i_i i° State: 451
Address: 941 SW 8th Street''-`'
Zip Code: u/(, Fax:
City: Pompano Beach State: FL
Phone No. �5 l c
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: CCC042787
IIf value of construction is $2500 or more, a. RECORDED Notice of Commencement is required.
0
DESIGNER/ENGINEER: `
Name: James Bushouse
Address: 3300 NE 10th Terrace #2
City: Pompano Beach
Zip:.33064 Phone
a _ Not Applica
FEE SIMPLE.TITLE HOLDER:
N a m e':' N/A�
Address:
City:
Zip: Phone:l
State: FI
_ Not. Applicable
"MORTGAGE COMPANY: _ Not Applicable
Name:. N/A
Address:
City: , State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: N/A
Address:
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 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 dAereby 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 al 1plications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming spools, 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
commencing work or recording vnur Nntirp of rnmmPnramPnt_
-Signature of Ownei /Lessee/Contr or as Agent for.Owner '
ractor/Lic se Holder
STATE OF FLORID
STATE OF FLORIDA
COUNTY OF V I— G! L
COUNTY OF aroward
The forgoing instrume before
The forgoing instrument s acknowledge before me
t was acknowledged me
this day of 20 by
this � day of 20 by
t4, h `-1,
John E Murray
Name of person make
g statement
Name°of person making statement
Personally Known OR
Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced L
Produced
(Signature of N: ary Public- State of FI ida)
(Signature of N ary Public- State of F o ida )
"Pav Pia MARYANN PAGE
2° ..... e
aP'O &a o MARYANN PAGE �
Comm!s*i a MYCOMMISSION9FF227587 (Seal)
EXPIRES: May 5, 2019
Commivi . MY COMMISSION# FF 227587 (Seal) .
EXPIRES: May 5, 2019
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rEOFF'.oa`O BondedThruBudgotNotaryServices
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVI
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
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