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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION/ 1 - APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED te: SCAN O Permit Number: ENV Sao Lucie O,oUR'�� - - Building Permit Application ing and Development Services ng and Code Regulation Division V' A F rt Pierce FL 34982 RECEIVED JUN 2 91019 Permitting Department St. Lucie County, 0VV rrgrnra venue, o 'hone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential Y— =RMIT APPLICATION FOR: P linerUODIF �v� F) To Select from dro box, click arrow at the end of ZOPOSED IMPROVEMENT LOCATION: dress:% 04tJOA W S i A LN . PorL- ;al Description: S.-i' Lye_k1z G 4<.o',a �, :�kf, 3 E, L-ID VSLA6'5 cy- v5 2 �tlu-L-,r-sS �o RS\W gr i-es; vas �r4 Da �,S3S_a►-�3 )pertyTaxlD#: Lot No. e Plan Name: Block No. T Aect Name: . backs Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK:' ., i . .. 1 1, 11 Lo "A=j A U v nn i N \ -V\ CZo o i=o V r1� . 0 ­� rrt- \.-A o n^ 'F_ , ON_STR;U:CTION INFORMATION: dclitionalwor to I bfe e rmed under tispermit-check all t= appy: UHVAC Gas Tank ❑Gas Piping _ Shutters a Windows/Doors Electric 0 Plumbing Sprinklers Generator &oof 3 Roof pitch otaI Sq: Ft of.Construction: r 3S . Ft. of First Floor: �3? ost of Construction: $ i'7 . oo Utilities: _ Sewer ElSeptic Building Height: \© ; WNER/LESSEE: CONTRACTOR: ; I1' r ame �� S�S�L�i f 1iE7_ L-OtZ\CoV-_ Name: JOHN E MURRAY Company: AMS INC. Address: V'? ArA Q,AL.s,l C-) LN �ity: 1 State:1L Address: 941 SW 8 STREET ip Code: Fax: N /2 City: POMPANO BEACH State: FL hone No. 3 ` Zip Code: 33069 Fax: 954-782-0095 -Mail: C-A Phone No. 800-226-6677 ill in fee simple Title Holder on next page ( if different E-Mail:.maryannp@amsoffia.com rom the Owner listed above) State or County License: CCC042787 value of construction -is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL'CONSTRUCT'ION,.LIEN LAW;INFORMATION,; ; Not Applicable Name: JAMES BUSHOUSE Address: 3300NE10TERRACE ,APT#24 City: POMPANO BEACH State: FL Zip: 33064 Phone 954-956-2203 FEE SIMPLE TITLE-HOLDER-,"'`'- .— Not Applicable Name: Address: Tt7t�,v 2 City: on2-r- s-r Zip: Phone• - MORTGAGE COMPANY: D�\ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: _i�LNot Applicable Name: 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 Counter makes no representation that is granting a permit will authorize the ermit 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 pr"3erty. A Notice of Commencement must be recorded and posted on the jobsite before the first insp_evpicr6 If you intend to obtain financing, consult wit gder or an attorney before commencing wocKoKrecording vour Notice of Commencement. Signatuc ;a . - ner,/ Lgsseej ntrktoKas Agent for owner tor/License Ho Er 5� gr�at=OFORIDA STATE OF FLORIDA / STAT COUNTY OF R�c,� COUNTY OF BRowmD The forgoing instrument wasacknowledged before me The forgoing instrument was acknowledged before me this � day of thisl`day of 20,M by H E „ �./�,� F?-rZ r�'#y JOHN E MURRAY Name of person making statement Name of person making statement Personally Known ' X__ OR Produced Identification Personally Known x OR Produced Identification Type of Identification 'z Type of Identification R Produced N z Produced it o JCt C= LL N LLJ m _O $ (Signature of Notary Public- State of Florida) o x (Signature of Notary Public- State of Florida)ME CC 2 LU Commission No.i-�s I-i)q (Seal) * Commission No. i4 \ (Seal) z m d r 01 K REVIEWS FRONT ZONING SUPERVISOR PLANS EGETATION SEA TURTLE MaN VE COUNTER REVIEW REVIEW REVI REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED 7 2 Rev. 8/2/17 NOTICE OF COMMENCEMENT Pernitt No. Tax Folio No.3u VLk • SO t - t-201 0223 State f Florida County of St. Lucie The Undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the (lowing information is provided in this Notice of Commencement. f,--�Gt:jZoCnQS "•36-�-t0 GLAKs' cLD as, ty F L�F---'.r As krJ oT".s ;LT S,. Lega Description of Property: (and street address if available): Gen al description of improvement: �rJS i� �'`' W ^^� �vrh 4-7-'0 o� oV"S-`r� ®r'a E-) ` Mo r information or Lessee information if the Lessee contracted for the improvement: is \�7 �� i� A LAWS \ A LrJ S' D 2-,-- S"T- ILK-1� ��L 3 � � ;tin property: and address of fee simple titleholder (if different from Owner listed above): �r,E c�u„..or,r46 ejzrzp ictor's Name: Y1��S �i�1t: ctor Address: c�i Lk\ S %— S-`N Sr- Pow 1v0 �3cy �-330b313hone Number; Ica • aa� da�� ? •.r (if applicable, a copy of the payment bond is attached): Amount of bond: $ and address: r-,) A Phone number: "' "' n 7 X r Name: Phone Number: 's address: is within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Sect'j':t; 0 .(1)(a)7., Florida Statutes: Phone Number: is: tion to himself or herself, owner designates of to receive a copy c r;':; s Notice as provided in Section 713.13(1)(b), Florida Statutek number of person or entity designated by owner: :ion date of notice of commencement: (the expiration date may not be before the completion of construction and final payment to the tor, but will be 1 year from the date of recording unless a different date is specified) ING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED PER PAYMENTS UNDER CHAPTER 713, PART i, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR VEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST MON. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR DING YOUR NOTICE OF COMMENCEMENT. airy of perjury, I declare t I have read the foregoing notice of commencement and that the facts stated therein are true to the best of rwl geand be'ef. l� iture of Owner or Less , or Owner's or Lesseeigodrized Officer/Director/Partner/Manager •dr► OWN 'Q'Z � V � � Q L•i=SS�r (Sigr atory's Title/Office) The f egoing Instrument was acknowledged before me'this� day of S,,r 4 £ , 20 ►, Bycri SS �M. as S Eat ( wsJt=1L for R� SS�� un • i LORD 6 E Name of Person Type of authority (e.g.officertrustee) Party on behalf of whom instrument was executied �•••e�% ALAN MILLER MY COMMISSION # FF 19549f ersonally known'kor produced Identification (Signo ture of Notary Public - State of Florida) Nr , EXPIRES: May 5, 2019 (Prim Type, or Stamp Commissioned Name of Notary Pu ?Ejos Bonded Thru Budget Notary ServiceFype of Identification produced G-,,.'k of Court - (772)462-6!, -,,8 201 South Indian River Dr