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BUILDING PERMIT APPLICATION
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �j �RprETVED, Date: Permit Number: u II � . 2018 Permitting St. Luce apartment County -- Building Permit Application Planning and Development Services Building and Code Regulation Division av 2300 Virginia Avenue, Fort Pierce FL 34982 Cube count Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential �_— Y Address: 1 hc2A�a� �[a�`^r,�� ca- FT•P�r-riLE r►- 3�a�i�l Legal Description: SEC_01 W N 3t*s E Property Tax ID#: V300C;'O1 -0c>01 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: .,DETAILED DESCRIPTION .OFWORK: ��S "rc�-� (.� � • ��,y �t� v bF cio �+-�� A-w.N., r� ��„� czo ©-F'o v �s� p rJ ,Pt 4^-" "1 \ Lr (a-• 4 CC) FLvrL !Z CONSTRUCTI.O.N INFORMATION: Additional work to be performed under this permit -check all apply: E1HVAC Gas Tank ❑Gas Piping _ Shutters Windows/Doors Electric 0 Plumbing Sprinklers Generator ® Roof 3"�\ Roof pitch Total Sq. Ft of Construction: \'-? vc� Cost of Construction: $ �vo • oa S Ft. of First Floor: _ Utilities:cn Sewer E]Septic Building Height: U=> OWNER/LESSEE: -CONTRACTOR: Name Name: JOHN E MURRAY ` Address: Company: AMS INC. City: 'F-'T- State: EL_ Address: 941 SW 8 STREET Zip Code: Fax: City: POMPANO BEACH State: FL Phone No. fig\ - $`b \ - 7 `ram Zip Code: 33069 Fax: 954-782=0995 Phone No. 800-226-6677 E-Mail: rJ IA- Fill ini fee simple Title Holder on next page (if different E-Mail: maryannp@amsoffla.com from the Owner listed above) State or County License: CCC042787 If value of construction -is $2500 or more, a RECORDED Notice of Commencement is required. T SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION;' v._ . DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: g Not Applicable Name- DAMES BUSHOUSE Name: Address: 3300NE10TERRACE APT#24 Address: City:,?oMPANoaEACH State: FL City: State: Zip: 33064 Phone954-956-2203 Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: >(.,Not Applicable Name:.W�-/NriF. aoiL_ok , Cori.P Name: Address:SLJ c' r°l /)kg- Address: . City: vN -, \ City: Zip: Phone: Zip:33Lg6 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 SUCA, 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 i WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for I improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite i before the first inspection. if you intend to obtain financing, consult with lender or an attorney before commencine walk or recording vour Notice of Commencement. I� II Signat - ; f e ssee/Contractor as Agent for owner _ �. , As igaa r Con dcttooT/Licen-se:Hotder STATE OF FLORI A STATE OF FLORIDA COUNTY OF IDCLZ,(_J rLt;� COUNTY OF BRDwARD The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me thiscdayof 20 (Sby thisC)_dayof 20\'S'by i JOHN E MURRAY Name of person making statement Name of person making statement Personally Known ' OR Produced Identification Personally Known x OR Produced Identification Type o Iden if!cation Type of Identification Produced Produced (Signature o1 Notary Public- State of Florida) (Signature of Votary Public- State of Florida ) a°,` Ak P&,,, ALAN MILLER �o�� •••,e�% ALAN MILLER , Commisi MY COMMISSION # FF 195499(Seal) MY COMMISSION # FF 195499 (Seal) commissIN." EXPIRES: May 5, 2019 Bonded Thru Budgel Notary Services fArFOF XPIHE8:May5,2019 rFOFFV6O Bonded Thru Budget Notary Services F�0P`O REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE �I MANGROVE, COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE O, COMPLETED Rev. 8/2/17