HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABIE;iNFO MUST BE COMPLETED Ft>!Et APPOCATIOIV TO 6E ACCEPTED:. ::
Date .5 y 1 F5. Permit Number OV; I:
ECEITCD MAY 13 201
Building Permit Application
Planning and gevietoptnent Servkes
udding and Code Regulati n Oivisi6n
2300,Virginia Avenue,Fort Memo FL 34982
Phone:(772)1462A553,''Fax:(712)462.;1.578` Commercia# Residenf ai v`
PERMIT APPLICATION FOR:„.Mechanical
P�ROPC?SE61MPROVEMEN7 C4CATI4N.
Address:�_� � . .. cel a0ry- 1 l �j
Legal Description-"Fr','" %_S. z-2_: i `l� C�Y"^�� � - ' ._ UZA- S2-
Property Tax ID Lot No:_ �
Site Plan Name:
Block No:
Pro ect Name•
1c _
Setbacks Front Back: Riight Side: . LeftSide:
DETA LE D SCRIPTIt3N OF WORK
CONSON INFORMATION.
ltlorfa wo - o.,e e Orme under Is perm -.Check:a app y.
t=1VAC Gas Tank ❑Cas Piping _ Shutters E]WindoWsf Doors
�fiectrlc.., O Plumbing5prinklers Generator. ES;Roof
,-Total Sq.Ft of Construciion � 9 Sq.Ft:of First Floor:
Cost-of Construction,.-$" 1'2_U).P"). Utilities:. 5ewer0Septic Building Height:
Cl1NI?IER/LE55E� CONTRACTt�R.,
Naifie RAIL;CANTRI iL.
Address:lt4c )C:3 AC)-f'N c,JC�, Company: AMTEK'41R CONDITIONING
City ("N- - \C�a ._ Statest Address:. 571 MEF2CANTILE PL#8-12
Zip Code:� `l Fax: -=-- City, PORT$T:LUGIE. State:FL
-Phone.No."i-1 1-. '-FAQ Zip code: 34986 Fax:
E-Mail:. -7 -7 ` _ ' Phflne:No. 772-801-3465
,.Fill In.fee:simple Title Molder:on.next page(If different E-Mail: emtekac@gmeil.com:Jim the Owner listed>_above) State orCouiity License: ca
c1815639
of vaiae;ofconshuctioa is.S2SW or mare,a RECORDED Notice of Commencement.is required..
r
5i)p tEMENT;AL CO,NSTRUCTION L1E11�LAW INK
ORMATION
DESIGNER/ENGINEER __ Nat Applicable MORTGAGE COMPANY:F < Not Applicable:
Name Name:
Address- Address:
City: State: City. State:
Zip; Piione: Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY:' Not Applicable
Name: Name:
Address: Address
City' City
Zip: Phone: Zip:' Phone:
OWNER/CONTRACTOR AFFIDVi3:Application is hereby made to obtain a permit to do the work and installation as indicated:
f'certify that nowork or installation has commenced prior to the issuance of a permit,
St.Lucie Count makes:no representation that is granting a permit will authorize the..ppermit holder to build the subject structure
Which is in conflict with any applicable Home Owners Assoc ratio n 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.
1n consideration of the granting-of this requested permit,..I do.hereby agree that l will,in all respects;perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The#allowing building pernnit:applications are exempt from undergoing a fulLconcurrency 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
commencingworkor recordin our.Notice of.Commencement.
Sfgnatur' of owner/Agent/Lessee Signature.of C ntractor0ense Holder
STATE,K)F FLORIDA. STATE OF FLORIDA
COUNTY OF -4"%.e . COUNTY OF
The for oing irsstrument was aeknowlec! ed before me The far ing instrumerst was acknowledged before:me
this ("/ day of_ 20 (�by thlsMay of Mao 20[by
(Name of person riowledging). (Name of son acknowledging).
(Signature.of Notary Public-State.of Florida} (Signature of Notary Public-State of Florida)
Personally Known. ✓ OR ProducedIdentification, Personally Knowny .. OR Produced Identification
Type of identification,Produced Type-of identification Produced
,.��"!;�"� Otg§flH RUSSELL pwn"�, 1 dt H RUSSELL
Commission Na. ,tai �'•�. Commission No.. ,a `n Notary Pubh6-state of Florida
Notary ublic-State of Florida ;r �'
'=•: :•c My Comm.Expires Nov 34,2018 ?.;
%A-My Comm.Expires Nov 30,241 B.
�: 17,9U.-
Commission 17 630 o,, ommi
`" �"r: °�°� Bonded through National Notary Assn.
RBVISECI 07115/2414 Bonded through Nalional Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR ' PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW 'REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED .
DATE
COMPLETED