HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I � Permit Number:
SCANNED
�. RECEIVED
------ -- St Lt ripnlo��
guildiing Permit Application APR 0,410
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) 462-157 Commercial Residentia'I T
PERMIT APPLICATION FOR: To'Sel//ct from dropbox, click arrow at the end of line Pq
PROPOSED IMPROVEMENT LOCATION
_
Address: C GvAy R ► -N I P'o2-3- S� Ly c -A V "-Z 3 \-i sa
Legal Description,: 5rr- I.ve_t.F__ 6P1n0SJ6
1.F: ss f-L b 'rL/_C_ IW r`r`
Property Tax ID #: 3L\\ t'1 — �t71 �'� Oi 00 O- ci
Site Plan Name:
Project Name: /
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION O,F WORK
o
BF V S',-
Lot No.
Block No.
CONSTRUCTION INFORMATION.
A_ I
Additional work to flas"Tank
orme under this permit— c ec a apply:
❑HVAC Gas Piping _Shutters .Q Windows/Doors
FRI Electric ❑ Plumbing ❑Sprinklers ❑ Generator I I 3-1 Roof pitch
Total Sq. Ft of Construction.0 30 S . Ft. of First Floor: kd3a
Cost of Construction. $ �l bo• ce Utilities:Sewer 11 Septic Building Height: \c:;
OWNER%LESSE:E . _
CONTRACTOR
Name i�S30rLCr1= G� - LF�3)-AN L
Name: Sohn E. Murray,.
Address:., C�wA�r 9�1J
p .,AMS•Inc. '
any.
Company:
City: ' Po"� /S'? I ;.u. State: !—rC_
Address:. 941 SW 8th Street
Zip Code: 3�'4 3r , Fax:
City: Pompano Beach State: FI
Phone No. �)d-7 -- S oiO ®
Zip Code: 33069 Fax: 954-782-0995
I
E-Mail: i rJ �1:4_
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 $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAOAWNLNFORMATION::
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: JamesBushouse Name:
Address: 3300 NE 4oth Terrace Address:
City: Pompano Beach State: Fi City: State:
Zip: 33064 Phone: 954-956-2203 ` Zip: Phone:
FEE SIIVIPLE'TITLE HOLDER: _ Not Applicable
Name: MvIL-0cr4f6 wn—P
Address: %aSc> 4 5yJ 1;.7 r4P oAvr
City: M, A r4\ k L_
Zip:Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 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 to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
re of Owner/Lessee/Contractor as Agent for Owner `1�: Sign-aature df Contractor/License Ho
STATE OF FLORIDA I STATE OF Fl.
COUNTY OF 15. -- "Lt T-� COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this R day of -3- 20 11 by this _d\,_ day of \.)nnN 20 J_S:'by
A- _ 1—P� N L I John E. Murray
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known �_ OR Produced Identification
Type of Identification Produced
SPRY PU@!i �,o :....• � ALAN MILLER
Commission No. 1=F\ciS�-1 * a)MYCOMMISSION IiFF
EXPIRES: May 5, e
Revised 07/15/2014
(Signature of Notary Public- State of Florida )
Personally Known A_ OR Produced Identification
Type of Identification Produced
�ot� •••.B�% ALAN MILLER
commission Nab i IIiStig9 Y�QMMISSION ti FF 195499
EXXPIRES: May 5, 2019
OFF1pP\�e Bonded Thru Budget Notary Services
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