HomeMy WebLinkAboutBuilding Permit Application ALL'APPLICABLE INFO MUST BE,COMPLETED FOR APPLICATION TO BE ACCEPTED
Dar r
te:l Q - - Permit Number: L aCo (J
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-tOCATIQW
Address: cLqq ! r
Legal Description:�� 1 �► r-z,
Property Tax ID'#: oc)o I - f n Lot No._
Site Plan Name: Block No.
Project Name: s
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OPWORK:
CONSTRUCTION INFORMATION:
i ona rmed under this permit-check all that apply:
68
I Ad
HVAC Gas Tank [:]Gas Piping _Shutters Windows/Doors
Electric Plumbing Sprinklers ..Generator U Roof
-11
Total Sq.Ft of Construction: 5 Ft.of First Floor:
Cost of Construction:$����"amt_•Cy Utilities:[]Sewer OSeptic Building Height:
OJVN ERAESSEE: CONTRACTOR:
Name Name: CRAIG CANTRELL
AddressLb—N( Company: AMTEK-AIR CONDITIONING
Cit
Y . (LEE State:FL Address: 571 MERCANTILE PL#B-12
Zip Code? �) Fax: City: PORT ST.LUCIE State:FL
Phone No.—T"11-;l.-4(00 ~ I Zip Code: 84986 Fax:
E-Mail: Phone No. 772-801-3465
Fill In fee simple Title Holder on next page(If different k-Mail: amtekac a@gmaii.com
from the Owner listed-above) State or County License: cacl816639
If value of construction is S2SOO or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN Lp►1iN INEO.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.
SignaturAe`6f Owner/Agent/Lessee Signature of C ntractor/License Holder
STATE OF FLORIDA STATE.OF FLORIDA
COUNTY OF 1."e.Le COUNTY OF "f—l aci-e-
The forgoing instrument was acknowled ed before me The forgoing instrument was acknowledged before me
this y of <nkf 20LM by this }day of 20Uby
(Name of perqJ acknowledging) (Name of perso a nowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known V OR Produced Identification Personally Known ✓ OR Prod c I e 'f
Type of Identification F ype of Identification Produc nFaORAH RUSSELL
0.r np i
DEBORAH RUSSELL
•,ot,�+r�oe�,,, ;•�" "`o; Notary Public-State of Flo a
Commission No. :r �s Not�431�blic-State of Florida Commission No. _ *�• }�mm.Expires Nov 30, 18
_•: My Comm.Expires Nov 30,201 %". "oc commission#FF 1796
of Fd through National Notary sn.
Bonded through National Notary Assn.
Revised 07/15/201 .rte
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED