HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE lNFO:MUST BE COMPLETED FOR APPUCATION T0:8E ACCEPTED'
i3ates'S :1 5. Permit-Number.
`k RECEIVED MAY 01
Building Permit Application
Planning and Development Servfces
8uilding_and Code Regulation Division
2300 Virginia Avenue;Fort Pierce F134982
Phone:(772)462:5553. Fax:(772)462-1578' CCImme t18( Re$identlai
PERMIT APPI:ICATION FOR: .Mechanical
PROP't IMPROVEMENT i.C1CATICIM:
Address: 1. i° 1.c -
Legal Description:
Property.Tax ID#: 0p0 , 5 Lot No.
Site Plan.Name. ti (�ti i li �.-� �5 a e t i4 �� l ttC Block No
Project Name:
-Setbacks Front Backs RigHtSide:.: Left Side:
_..
D64 LO PE to C}F 1N+DRK
Y,a 0-i- i ae�me -t- - - I: Sem P
.-CON 5TRUCTION,lNFORMATION. .
Additional wqr.. o eorrYte under. is permit–.c ec .a appy
iVAC bas Tank as Piping Shutters o Windows/Doors
. tiectr'ic ,Plumbing QSprinklers �Geri4 for 0.R.oof
Tota[Sq.Ft of Construction SQ.Ft:of First Floor:
Cost Of Construction $ Utilities: Seiner Septic, Building Height
ClWNER 1.fS5EE : CONTRACTOR
Name___7��t't S ems_ Name: CRAIG.CAWTRE t
Address: c>SP_�L.o. Company:.AMTEK'AIR CONDITIONING
City:, �� t—'.(P�Cf�. State:FL Address: 571 MERCANTILE PL#D8l2.
Zip Code: 224-15 5 ( Fax: City PORT ST.LUCIE state:FL
Phone:Nci1'�'(� �Il – D ZipCode:.349$6 Fax:
E-Mail:. Phone.No. 772-801-3465
Fill In fee.sirmple Title Holder.on next page(if different. . E-Mail: amtekac gmail:com
from the Owner listtd above): State or County License: cac1816639
:"If—Value;of construction is$2500.or more,aRECORDED Not(ce of Commencement is.required.
SUPPLEMENTAL CO:NSTRUCTMON LIENIAW tNt=0RMi4TlON
DESIGNER/ENGINEER: _Not ApplicableMORTGAGE.COMPANY _ Not Applicable .
Marne: Name:
Address: Address:
City State: City: —State:
Zip: Phone: Zip: Phone
FEESIMPLE TITLEHOLDER: 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 certiN that no work or installat(on has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a peri-nitwill authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules;bylaws or and covenants thatmay 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 Ainendmerits.
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 accessoryuses to another non:residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result In yourpaying 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
commencin work.or retordin our,Notice,of Commencement. .
Signatur of Owner/Agent/ Signature of C nti.actor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFP i`P COUNTY OF
Ls
The for oink instrutnent was acknowled ed before me The for Ding instrument was acknowledged before me
this i s day of_ �;20=by this day of Yii�G� 20�by
t 4 rGL��G rA (�t l
(Name of-pe acknowledging). (Name of pers acknowledging),
{Signature of Notary.Public-State.of Florida) (Signature of Notary Pfublic<State of Florida}
Personally Known Y OR Produced Identification, Personally Known 1i .OR..Produced Identification
Type;of identification,Produced Type of identification Produced /
Commission NO. tiuuq,,, (Seal) ISSIon NO. -,- ..L+q (��]BQRAH RUSSELL
s DEBORAH RUSSELL °
:'_°*�►`�- Notary Public-Stale of Ft rich ��.•` *, Notary Public-State o!Florid
- * -
"+ Commission#FF 179630
Commission#FF 179630
yr 4:
Revised 07/15,1,2.014 %°`F'O�•`` ,, ' �fog. Bonded through National Notary Ass
vi
'mo. Bonded through National Notary Assn.
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