HomeMy WebLinkAboutBuilding Permit Application AlkA.PPLICABL#INFO ST BE`COMPIETED FOR APPLICATION TO SE ACCEPTED
Date: Permit Number.
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)4624578 Commercial Residential
PERMIT APPLICATION FOR: Mechanical
PROPOSED.IMPROVEMENT LOCATION.*, c-�
Address: L-r-3 G ..1jf r-"
Legal Description:
Property Tax_ID.#A3(?a - Q Lot-No.
Site.Piari Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED_-DESCRIPTION:OF'WORK:.
CONSTRUCTION INFORMATION::
Addr-LbonaV orktobeDertormed under this perms -check ali=appy:
VAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric Plumbing QSprinklers r I Generator Q Roof
Total Sq.Ft of Construction: SQ.Ft.of First Floor:
Cost of Construction:$ JE� � Utilities:n Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR: .
Name Name: CRAIG CANTRELL
Address:l-V)q U3AL X-3 rn P0v-vc> fr Company: AMTEK AIR CONDITIONING
City::`Pr State FL Address: 571 MERCANTILE PL#B-12
Zip CodeE�4 - Fax: City: PORT ST.LUCIE State:FL
Phone No. AL.—ill - 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@a gmail.com
from the Owner listed above) State or County License. cac1816639
Ifvalue of construction is$2500 or more,a RECORDED Notice ofCommencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIONS 7 _
.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
olderSTATE OF FLORIDA STATE OF FLORID
COUNTY OF f�l COUNTY OF1' .L.0 C.1
The forgoing instrument was acknowled ed before me The forgoing instrument was acknowledged before me
thiG 'day of Z-T3 s W e= 20by thisgS day of 76 L4ZZr 20®by
I c� Cay trrl2g;i� C'.P. �(-� CAcs n2L?=O
(Name of person acknow (Name of person acknowled ' g.
(Signature of Notary Public-State of Florida) (Signature of Notary Pu lic-State of Florida
Personally KnownORProduced Identification Personally Known OR Produced Identification
Type of IdentificatioLducedType of Identificati n 'roduced
Commission N :�� a CJ (Seal) Commission No. (Seal)
`.tiPHV
:° Notary Public-StateD178096
•'S ;iPHYP�a� SHAWN A RUSSELL
Revised 07 •oe; My Comm.Expires Ma ?2 c
,-
OFF�����` Commission#EE _, _ Notary Public-State of Florida .
REVIEWS FRONT ZONING SUPERVISOR PLANS G9(='°�4�l''N c� iTURTLEE 1 6MAN O.VE
COUNTER REVIEW REVIEW REVIEW R l W
DATE
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COMPLETED