HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUSTBECOMPLETED FOR APPLICATION TO BE ACCEPTED r
Date: �' I Permit Numbef=
L
I RFCEIVED
�J
- Building Permit Application NOV 13 2018
Planning and Development Services
Building and Code Regulation Division Permitting' Department
2300�Virginia Avenue, Fort Pierce FL 34982 St. U i e o u n ty, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERK41TAPPLICATION FOR: (,"'I"J.'
To Select from dropbox, click arrow at the end of line rww avEr-�L
:PROPOSED IMPROVEMENT LOCATION:
Address: 3\3 671-Tow(N iLJay o<-LT-9 iz-szC_r i L_ 3ySt-v6
1 f
Legal Description:Sf-c- _13 s ouici 3LkS 0,546F_ ko6_ Sc_ �l �-t oFNW I t-► - t_ sS rJ loa rP�
1�y6 �cor f' rzlw C.14Erx-oKE- Ay AND lcoF
Property Tax ID #: \ Lk_7>S 4.kO - ca0cs3 o00 ^( Lot No.
Site Plan Name: Block No.
Project Name: SIM'
Setbacks Front Back: Right Side: Left Side:
BY
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I'DETAI,ILED DESCRIPTION OF WORK: �II
o ,�z) �A .�£ oC-�F-3� A- L. J-Vlf'J � v [Z oo' a v'�_rL
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CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit -check all t= apply:
�HVAC LJ Gas Tank ❑Gas Piping _ Shutters [] Windows/Doors
0 Electric El Plumbing Sprinklers 1:1 Generator E Roof 3�. Roof pitch
Total Sq. Ft of Construction: t7 o<X�
Cost of Construction: $ C- CDt7Q0. oc7
S Ft
of First Floor: _
Utilities: LJ Sewer ElSeptic
Building Height: \o
OWNER/LESSEE:
CONTRACTOR:
Name R�r3Ect�- LF �32 m i�l
Name: JOHN E MURRAY.
Address: 3 i3 b1_*1- flyje! w ,Qy
Company: AMS INC.
City: , p k yrzcg State:'_
Address: 941 SW 8 STREET
Zip Code: 3y� �4o Fax:
City: POMPANO BEACH State: FL
Phone No. 7i ^ �.o� - 6Li
Zip Code: 33069 Fax: 954-782-0995
E-Mail: rl 1 /}-
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
If value of constructionJs $2500 or more, a RECORDED Notice of Commencement is required.
d-
:SUPPLNENTAL CQNSTRUCTL.ON:.LIEN LA'1N`INF:URMATION _
DESIGNER/ENGINEER: - - -' —Not Applicable
Name! JAMESBUSH6*
Address 3300NE 1#-.rERRAC,E �AP,r #24
City: POMPANO BEACH State: FL
Zip: 33064 c, Phone'954-956-2203
FEE SIMPLE TITLE, HOLDER:__.. , _ ., Not Applicable
Name: (Z°FL2C
Address:'60urE�- =-'FT-' 16®1
City:- N ZW - `f o cL -_ N
Zip: %cd19 Pho e•
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: XNot Applicable
Name:
Address: '
City:
Zip: Phone: L
I
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. i
St. Lucie County 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, 1 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 inspectiyou intend to obtain financing, cowith lender or an attorney be
on nsfore
commencine work or er'cardine vour Notice of Commenceme
�I
1Signat tire. of-Owner/1essee/ ntractor as Agent for Owner
nat re C ntractor/lace, ns�e�Ho der
STATE OF FLORIDA
STATE OF LORIDA
COUNTY OF 1 Lo
COUN OF BRomm
The ffL�or,ggoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this orb day of Dc-:)- Pa q L . 20 IS by
this day of 20M by
JOHN E MURRAY
Name of person making statement
Name of person making statement
Personally Known _P<'- OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
I
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida)
.1 �011 ***. % ALAN MILLER
Commission N�C�F ��15 (dOMMISSION # FF 195499
*
�aa' PCB ' LAN MILLER 1
Commission No. F 19S �° : ""••`'O
MISSION # FF 195499
EXPIRES: May 5, 2019
* * EXPIRES: May 5, 2019
RrFOF FL°��O Bonded Thru Budget Notary Services
'"raT - 6p Bonded Thru Budget Notary Services
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DATE
COMPLETED
Rev. 8/2/17