HomeMy WebLinkAboutBuilding Permit Application ALL APPUCABLEINFY MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a Permit Number.
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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:
Legal Description: "J �-(
Property Tax ID#: -;_�4i 10 '.�fv� s bC>3(— Lot No.
Site Plan Name: Block No.
Project Name: x71�?Gf.ni ' ' n
Setbacks Front Back: Right Side: Left Side:
DETAILED.DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:,
Additional work o e Orme un er this permit—check a appy:
NA HVAC M Gas Tank []Gas Piping _Shutters ❑Windows/Doors
u
Electric 0 Plumbing Sprinklers FIGenerator U Roof
Total Sq.Ft of Construction: . So. Ft.of First Floor:
Cost of Construction:$ �"� `J� �� Utilities: Sewer Septic Building Weight:
OWNER/LESSE,E: ` CONTRACTOR:
/V_1D 2 15-C ti Name: CRAIG CANTRELL
Address:, "�� iG'�l 4S( ai; Company: AMTEK AIR CONDITIONING
City: - � r C State:FIL Address: 571 MERCANTILE PL#B-12
Zip Code: 3-4 1) rc'�_L Fax: City: PORT ST.LUCIE State:FL
Phone No. ,4 r ? o Zip Code: 34986 Fax-
E-Mail: Phone No. 772-801-3465
Fill in fee simple Title Holder on next page(If different E-Mail: a(mtekac@gmaii.com
from the Owner listed above) State or County License: cacl816639
If value of construction Is$2500 or more,a RECORDED Notice of'Commencement Is requires!.
1127.S"2
RM5U 'PLEMENTAL CONSTRUCTION LIEN LAW INF4Cl0
ATI
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:
ddress: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.:tucle 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 ail 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.
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Signatur of.Owner/Agent/Lessee Signature of G nttactor/License Holder
STATE.OF FLORIDA STATE OF FLORIDA
COUNTY OF 5�+ 1, a COUNTY OF ,'S± I I LCi-e-
The forgo' g instrument was acknowledged before me The forgoing instrument was acknowledged before me
this� y of 1 01h,0 ,20 by this 3!2Nay of C�Y%4- 20®by
a1}�
(Name of Pers cknowledging} (Name of pers n acknowledging)
�_
(Signature of Notary Public-State of Florida} (Signature of Notary Public-State of Florida}
Personally Known v�" OR Produced identification Personally Known ZOR_Produced Identification,
Type of Identification Produced. Type of identification Produced
Commission No. Commission No. QRAH RUSSELL
DEBORAH RUSSELL
`,,UNARY flte('` w,ao y Notary Public•State of Florida
Public-State of Florida * ,� rpqNo
01
Notary* r 'S my comm.ExpiresNOV :;r o; Commission#FF 179630
Revised 07/15/20 ;r 'o`: Commission#FF 179630 '% ,;�;;°:�' Bonded through National Notary Assn
OF Bonded through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED