HomeMy WebLinkAboutBuilding Permit Application ALLAPPLICABLE INEQ MUST BE COMPLETEMFOR.APFUCATION TO BE ACCEPTED
Date: is Permit Number
.e'•"". y.1i y fi'^'�` l 1 E V EI V 7D JUL 2 i 406
Budding Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce F!34982
Phone:(772)461-1553 Fax:(772)462-1578 Commercial Residential 1/
PERMIT APPLICATION FOR: Mechanical
PR,, SEp IMPROVEMENT LQCATIQN,;
Address: 11 Jk61QC AV el
Legal Description: RcCi C4,,,, --i
Property Tax lD#: 0411k —61!5-- o+Qt opo '. Lot No.
Site Plan Name: . Block No. 5
Project Name: r*
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIONOF WORK:
'tD.Aj 1 ! veer PAC
CONSTRU
MORIN ORMATION: ,
itiona wor o e' a orme under is permit—c ec a appy:
Fu
rl Gas Tank QCas Piping _Shutters Windows/Doors
U Electric Q Plumbing ElSprinklers F�Generator U Roof
Total Sq.Ft of Construction: . 1 o6_5 So. Ft.of First Floor:
Cost of Construction:$ L-I•_16 >C Q Utilities:[]Sewer USeptic Building Height:
OWNERJL£SSEE: " CONTRACTOR:
Name Name: CRAIG CANTRELL
Address: It a Company: AMTEK AIR CONDITIONING
City: '�ca,4--f--._.I.�� State: Address: 571 MERCANTILE PL#B-12
Zip Code: , Ltq ffa Fax: �'J City: PORT ST.LUCIE State:FL
Phone No. Zip Code: 34986 Fax:
E-Mail: ----- �� Phone No. 772-841-3465
Fill in fee simple Title Holder on next page I If different E-Mail: amtekac@gmell.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 required.
SUPPLEMENTAL CQNSTRUCTIO:N LIEN,LAIN tNFO:RMATION f;�
1,.
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 thepermit 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.
Signature'of.Owner/Agent:/Lessee Signature of C ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF_ :2tj_t.t�,i-O� COUNTY OF 1-. L_"U,p,
The forgoing instrument was acknowled ed before me The forgoing instrument was acknowledged before me
this�'t'1_ ay of 20�by thiQ:QIfay of 20 ]by
(Name of pbdon acknowledging) (Name of per acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known __/OR Produced Identification Personally Known a//OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. =National
Commission No.
W'A""� SSELL �Pprn�")., DEBO USSELL
te of Florida a%�'�-
�± *�: Notary Public-State of Florida
Revised 07/15 N 10,zFF 179630 ^� "oc
rr�' 9, p�, Commission#FF 179630
V ��'� al Notary Assn. %°� ��'� 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