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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPUCATION TO BE ACCEPTED Date: !5 i Permit Number: RECEIVED JUN'03 29 Building Permit Application Planning and Development Services 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: EKMS �aKg Sid! Legal Description: L YmNM- Property Tax ID#:1�i' © �'" «j `-Q 1 Lot No._ 1 Site Plan Name: Block No. Project Name: �Crar Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION-.OF`WORK:. 10 CONSTRUCTION;INFORMATION: AdclitionalworKtobe-nertormedunder this perms -check all thaLt apply: &VAC Gas Tank []Gas Piping FIShutters Windows/Doors Electric Q Plumbing QSprinklers U Generator F�Roof Total Sq.Ft of Construction: J U S Ci` So.Ft.of First Floor: Cost of Construction:$ Utilities: OSeptic Building Height: OWNER/LESSEE: CONTRACTOR: NamefZIeYE`YC�aCiiCIAZ. �" 1�'L7C"r�if� 1"::;1J1;LVzl` Name: CRAiGCANTRELL Address: ama 10)U S1Cnuo_ Company: AMTEK AIR CONDITIONING City: } -,t-r ce- State:FL Address: 571 MERCANTILE PL#B-12 Zip Code:.;.`,_;.— Fax: . --�-� City: PORT ST.LUCIE State:FL Phone No.__- Zip Code: 34986 Fax. E-Mail: ---' Phone No. 772-801-3465 Fill In fee simple Title Holder on next page(If different E-Mail: amtekac 9mail-com from the Owner listed above) State or County Licenser caci 816639 If value of construction Is$2500 or more,a RECORDED Notice of Commencement Is required. S:lJPPLEMENTAL CONSTRUCTION LIEN t�41N tNFO:RMATION DESIGNER/ENGINEER: _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 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 our Notice of Commencement. Signatur,'of Owner/Agent/Lessee Signature of C ntractor/License Holder STATE OF FLORIDA STATE OF FLORIDA . COUNTY OF 5- 1. c . Lu[ e_. COUNTY OF S�l. The forgoing instrument was acknowledged before me The forgo ng instrurgent was acknowledged before me this-day of 20�by this day of 4jz± L 20 I]by .CQ,�Q (Name of person a k owledging) (Name of pers n cknowledging) (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known ✓ OR Produced Identification Personally Known V OR Produced Identification Type of Identification Produced a of Identification Produced ;;�n,,,� DEBORAH RUSSELL Commission No. `�'a, (15ffl1)i Public-State of Fb�i �o mission No. a����a (�I�AH RUSSELL My Comm.Expires Nov 30. . i F .� _app „� Notary Public-State of Florida FF 17353 i d, '•2 M Comm.Ex fires Nov 30,2018 Bonded through National N0,12'Y As, ;". oc Commission#FF 179630 Revised 07/15/2014 s "" ° °;;°P��, Bonded through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED