HomeMy WebLinkAboutBuilding Permit Application ALL APPI&ICAB"L INFQ:M ST BE COMPLETED FOR APPUCATIt�Id 7Q 9E ACCEPTED �--�
late: r Permit Number:
Building Permit Application
Planning.ond.Development Services
i4uilding and Code Regulation.Division
230,0 Virginia Avenue,.Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR:. Mechanical
PROPOSED.INJ_pR01tMENT LQCATl0,
Address: Q f`Vt•C-"
Legal Description:\ ' ��' 09 L40 W
Property Tex ID#: j " f�QZ— Q2.` `2-'ViSO Lot No.
Site:Pian Name: : Block No.
Project Name:
Setbacks Front Batik: Right Side: Left Side:
-DETAILED DESCRIPTI003F tAIORK..
CONSTRu.06RiN,FORMA 64.
i lona wor o. e' orme - u.n er. ,is 11 permit—eiitck a apply: .
HVAC GasTan.k F6as-Piping FJ Shutters. MWiindows/Doors
Electric D Plumbing oSprinklers Generator t...d Roof
Total Sq.Ft of Construction: "'t 5 .Ft.of First Floor:
Cost of Construction:$ 5q�.� utilities:0Sewer OSeptic Building Height:.
OWNER/LESSEE, CONTRACTOR
Name e. -` me: CRAIGCANTRELI.
Na
Address: k Company: AMT EK AIR CONDITIONING
CityP,c C P- State-.FL Address: 571 MERCANTILE PL#B-12
Zip Coder. j4 a.%a. Fax: City:: PORT ST.LUCIE State:FL
Phone No. 21p Code: 34985 Fax:
E-Mail: 4i rie4— Phone No. 772-801-3465
Pill in%e simple Title Holder oq next page I if different .E-Mail: amtekac@gmail:com
from the Owner listed above) State or County Licenser cavi 816639
if'value of construction Is$2500 or'mpre,a RECORDED Notice of.Cominentement is required.
hSUPPLEMENT
DESIGNER/ENGINEER:CONSTRUCTION LIEN LA1N;INFORMATION F
,.
. .,.: . .
_Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: 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 thepermit 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 Recorda 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 our Notice of Commencement.
Signatur of owner/Agent/Lessee Signature of C ntractor/License Holder
STATE OF FLORIDA STATE OF L1J-CFLORID�� _ ��
COUNTY OF St ze COUNTY OF LLeAC c
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thi ay of 20_0 by this � ay of 20�by
(Name of peKs3n acknowledging) (Name of pers cknowledging)
(Signature of Notary Publi -State of F orida) (Signature of Notary Public-State of Flonda)
Personally Known OR Produced Identification Personally Known __1_`OR.Produced Identification
Type of Identification Produced of Identification Pro Lumd
�.��pr'n��., DEBORAH RU ? �'nB4 DEBORAH
Commission No. �� ����SeN6tary Public-State of I fission No. :'a°. .o; No glrplic-State of Florida
• My Comm.Expires Nov 3 , :. ;•`My omm.Expires Nov 30,2018
=N Q= mission#FF 179530 �•, o�. Commission#FF 179630
Bonded through National Notafy ��, ,�� ane roug ational Notary Ass
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED