HomeMy WebLinkAboutBuilding Permit Application AI.! APPUCA8LE INFOMUSTBE:COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: t ' 5 ' � Permit Number: ��� lis
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Building Permit Application JUL 15 2015
Planning.arnd.Developinent Services
Building and Code.Regulation Division
2366 Virginia Avenue,,Fort Pierce Ft 34982
Phone:(772,)462-2553 Fax:(172)462-1578 Commercial Residential
PERMIT APPLICATION.FOR: Mechanical
PRQP:QSED-1IM0 dVEMENT.LOCATIO?N: .
Address: L-122
Legal Description:
Property Tax ID#: a a, t —g`- Lot No.�
Site.Plan Name: Block No.
Project Name: C'�n
Setbacks Front Back: Right Side: Left Side:
DE7AILED,D8CRIPTION OF WORK:
CO NSTRUCTIO IN;ED RMATION.
lona worK totia' e.armed under this permit-checK all tful appy:
HVAC .Gas Tank []Gas Piping _Shutters a Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction:. . Sq. Ft.of First Floor:
Cost-of-Construction:$ ' Utilities: Sewer[]Septic Building Height:
OWNERjl.ESSEE CONTRACTOR:
Name as I-,t)S Name: CRAIG CANTRELL
Address: Company. AMTEK AIR CONDITIONING
City:, Stale:FL Address: 571 MERCANTILE PL#6-12
Zip Code:. Fax: `"` City: PORT ST.LUCIE State:FL
Phone No. -- 0-2 125 Zip Code: 34986 Fax,
E-Mail: Phone No. 772=801-3465
Fill in fee simple Title Holder on next page.(if different E-Mail:.amtskac@o gmaii.com
from the Owner listed above) State or County License: caci 816639
if value of construction is S25W or more,a RECORdED Notice of'Commencement is required.
SU.I'PLEMENTAL C{?N TRUCTIO LIEN0'RMA`f14N
it
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 nowork 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. t
Signatur of.Owner/Agent/Lessee Signature of C ntractor/License Holder
STATE OF FLORID _-> r STATE OF FLORIDA
COUNTY OF . C_f.�[' c.`t COUNTY OF -4". L 1 c *-e-
The forgoing instrument was acknowledged before me The for ininstrument was acknowledged before me
this ASNay of Q e_ _ 20Z by this a5ay of_� 20_Mby
(Name of person aWowledging) (Name of perso ac nowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public--State of Florida)
Personally Known V--"-OR Produced Identification Personally Known OR Produced identification
Type of identificatio ;,�tu pa „, „s _ Type of identification Produced
DEBORAH RUSSELL DE���� RUSSELL
Commission No. -'�`PaY��B Notary(ii�-State of Florida Commission No. +PRS<''.
Notary Public-State of Florida
•: My Comm.Expires Nov 30,2018 •; •"c My Comm.rnmmiqqinn .4 FF',7AAqn
Expires Nov 30,2018
•,Foy F4o• ommiss+on i s 30
Bonded through National Notary Assn,
Bonded through National Notary Assn.
Revised 07/15/2'14,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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