HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED —
Date: SCANNED Permit Number: 05 /G 3
BY
r. - �' 6'rw ^' fit. (UCIe County RECEIVED
Building Permit Application MAY 2 21919
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 A�"D,n III
Address: o1'�;9 r4erryZs
Legal Description:
LJ
t9 ;Lsq ANfl Pcto VLr41A S\-)Q2'r: TrJ Gof"\Mor1 1=t_
Property Tax ID #: H oo'y (),, Lot No.IE8_
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Block No.
DETAILED DESCRIPTION OF WORK: 111
✓sn tt _ o V I ram.
0-4 H- 'C-Lo \oq czocv`^
CONSTRUCTION :INFORMATION:
Additional work to e e orme under tispermn-Checka apply:
In
0HVAC Gas Tank Gas Piping _ Shutters Q Windows/Doors a 1
Electric 0 Plumbing -Sprinklers Generator Roof 5 ' Roof pitch
Total Sq. Ft of Construction: 7112NA S Ft. of First Floor:
S
Cost of Construction: $ 000- co UtilitiesSeptic Building Height: 1a o`
OWNER/LESSEE: s
CONTRA(
fQ,R;
Nanier'K F1m rJt�-,?.,S- A-VA—P,
Nafne3JOHNE:MURRAY,
L]Li_U Y 9%1 Ci If
Address;.. , 5�t:>•Ni1 rr1S Ci w�
Company
City: =rTra� b r—._,J State:E—_L__
Zip Code: 3Vt9 s—1 Fax: .4 \ rA
Phone No. a\ 7 • 3Glt.
Address: 941 SW 8 STREET
City: POMPANO BEACH State: FL
Zip Code: 33069 Fax: 954-782-0995
Phone No. 800-226-6677
E-Mail: ,.! 1A
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: maryannp@amsofFla.com
State or County License: CCC042787
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name: JAMES BUSHOUSE
MORTGAGE COMPANY:
Name:
X Not Applicable
Address: 3300 NE 10MRRACE APTR24
Address:
City: POMPANO BEACH State: FL
Zip: aaesa Phoneesa-Bse-220a
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: xNot Applicable
Name:
BONDING COMPANY:
Name:
_, Not Applicable
Address:
Address: '
City:
City:
Zip: Phone:
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 priorto the issuance of a permit.
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 an 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, consu t with lender or an attorney before
rnmmencine wnrk�65recordine vour Notice of Commenceme
Sig r�atu e o ssee/Contractor as Agent for Owner
n'trattof/U-6ense-H�older
' na G;1FLORI.DA
STATE OF FLO A
STATE
COUNTYOF 32av n
COUNFBRow
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this)2D dayofW\&) .20a by
this k0 day of MAC/ ,20A'_� by
':lC7 N/'� Qr td\JrirLAf 1
JOHN EMURRAY
Name of person making statement
Name of person making statement
Personally Known �_ OR Produced Identification _
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- S atAgoFlorida) ALAN MILLER
(Signature of Notary Public- Statt3pfy4Fl4orida) AL4N MILLER
Commission NQ,6 kS iql r (�ITlsslonNGG28919f
Commission Now l • • gulyfslondGG288191
eorno�P' BondeThry Expires May
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17