HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1Q
'Date: Permit Number: �` !0 ,
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue,Fort Pierce FL,34982
Phone:(772)462ASS3 Fax:(172)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT.LOCATION:
Address:
Legal Description`tf 1e ::=C21 •f—_,.. e--VIE�
Property Tax ID#: 2 --_ , � - �` Lot-No..,,UL _
'Site,Plan Name: . Block No.i
Project'Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION` ,FVORK:. . .
2-.15
CONSTRUCTIO ;IN ORMATION:
Additional work to-be nertormed r this permit—check a appy:
HVAC Gas Tank ❑Gas Piping F]Shutters Windows/Doors
1 Electric 0 Plumbing Sprinklers F ]Generator F�Roof
Total 5q.Ft of Construction: SQ.Ft.of First Floor: IF3
Cost of Construction:$=T� r� Utilities:0Sewer 1:1Septic Building.Height:
OWNERAESSEE; ,CONTRACTOR;
Name: CRAIG CANTRELL
Add(ess: 1 l.Y Y1 1'd, Company: AMTEK AIR CONDITIONING
City: State:PL Address: 571 MERCANTILE PL#B-12
Zip Code:,% Fax: . City:, PORT'ST.LUCIE State:FL
Phone No. 0 Zip Code: 34986 Fax:
E-Mail:. Phone No. 772-801-3465
Fill in fee simple Title Holder on next page I if different E-Mail:.AmtekaC@9mai1.c0m
from the Owner listed above) State or County License: cac1816639
If value of construction Is$2500 or more,a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CQ'NSTRUCTIO'N LIEN LAW tNFr0R11/IATION`� y � �� � �E � �° � � i `'`
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip. Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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 permitto 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 tractor/License.Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �[.tC.i i° COUNTY OFa
The forgping instrument was acknowled ed before me The forgoing instrument was acknowledged before me
thisl�dayof 20�by this A—& 20UMby
1P C 0, F-e-A d
(Name of person a knowledging) (Name of person nowledging.)
(Signature of Notary Public,State of F orida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known t/ OR Produced Identification
Type.of Identification P oAu-k
mm I Type of Identification Produced
DEBORAH RUSSELLCommission No. Commission No. 1111, � RAH JU
3 ; Nota �lic-State of Florida �•MAN
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•. .•"o My Comm.Expires Nov 30,2018 ;:°. ;�: Notary Public-
Geffiffiliftem FF q79638 _ f •
�''eOF F`°¢•, Bonded through National Notary Assn. Commission Revised 07/15/20 Bonded through Nati
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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DATE
COMPLETED