HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE, INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: (/ SCANNED Permit Number: O r - C23�)_
BY
St. Lucie County
'' RECEIVE®
Building Permit Application
Planning and Development Services APR 1 3 2015
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION
-
Address: .1 jL C`. ja
Legal Description: J /a Y, 1— 'Q0=a. K ,�n� 1
rr
_ -M- 2_5
Property Tax ID Lot No,
Site Plan Name: Block No.
Project Name:'i
Setbacks Front Back: Right Sider _._ Left Side:
DETAILED DESCRIPTION OF WORK:. .
6X0AC_V Y�IO�C�`Mk_'(Z�- C) O'_ 3
. ;; MAT OW � '
Acid i Iona wo o e orme under is perms - c ec a a p p y:
HVAC rlGas Tank []Gas Piping _ Shutters. Windows/Doors
Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction:1_UQ S . Ft. of First Floor:
Cost of ConstruI ction: $6� Utilities:0Sewer OSeptic, Building Height:
OWN ER%LESSEE:
; CONTRACTOR: .
Name —
�P•yr_; 2�1 \Ia-10) � �,��}� y__
Name: CRAIG CANTRELL
Address:` Vp � r'C L II'l't_Qa � n
Company: AMTEK AIR CONDITIONING
City: _ �i f rC� . State: Fl.
Address: 571 MERCANTILE PL # B-12
Zip Code:,�%%� Fax:
City: PORT ST. LUCIE State. FL
Phone No: -T 12- - BON- 314( S
Zip Code: 34986 Fax
E-Mail:
Phone No. 772-801-3465
Fill In fee simple Title. Holder on next page I if different
E-Mail: amtskac@gmail.com
from the Ownei listed above)
State or County License: cac1816639
- - - -------- ------ -- ---- �• •••�•.., ....wwnr..v .wNvc V-VIAMICIRCITICnIt M regUirea.
t
SUPPLEMENTAL CONSTRUCTION LIEN LA►VV INFORMATION.
J
,DESIGNER/EN ,... •:... , _,.,. ._
GINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
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 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. ,^,
Signatur of.Owner/ Agent/ Lessee Signature of C ntractor/License Holder
STATE OF FLORID , STATE OF FLORID
COUNTY OF �- / j& `Cr1� COUNTY OF A� . LCA GI
The forgging instrument was acknowled ed before me
this l3 day of _, 20La by
(Name of pers n acknowledging )
i
(Signature of Notary Public -State of Florida )
Personally Known '✓ OR Produced Identification
Type of Identification Prod_ucgJ
The forgoing instrument w s acknowledged before me
this Mday
of 20=1by
cai'gI
(Name of p n acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known I/OR Produced Identification
Type of Identification Produced
DEBORAH RUSSELL
Commission No. ,.sPaYn"B�
Notary Pub(i6")ate of Florida Commission No.
°. ; ; My Comm. Expires Nov 30, 2018
�''.° .� ��� Bonded through National Notary Assn.
Revised 07/1
.dA.Q,aRUSSELL
NoWlibliC . State of Florida
MY Comm. jwExP rt
A FF 179630
Bonded through National
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