HomeMy WebLinkAboutBuilding Permit Application ALL;APPLICABLE INFO_MUST BE°COMPLETED FOR APPIJCATIONTO BE ACCEPTED FF11 / Q r
Date:_ Permit Number: RECEIVED
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MYiA
Building Permit Application AUG 12 2015
Planning and Development Services
Building and Cade.Regulation Division
2306 Virginia Avenue,Fort Pierce F134982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Mechanical
'PROPOSEU IMPRO.VEMENTTLOCATION:
Address: W Q 4 S
Legal Description: (Vy taiP_V_10uta 3
Property Tax ID#:aT. 26- f'I PS 0 G2 I-,- C? xn Lot No.�,�
Site Plan Name: Block No.A i _
Project Name:7:Sb411-1
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
p p c IKP Q U I� LXD!Zc u to 1<c,3 W elb;r
CONSTRUCTION.INFORMATION:
Additional work o e Elartormed under this permit-check all=apply:
WAC Gas Tank ❑Gas Piping _Shutters F-]Windows/Doors
Electric Plumbing Sprinklers Generator Roof
Total Sq:Ft of Construction:cwt i C- SQ. Ft.of First Floor:
Cost of Construction:$ '4q5 c) Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name,=CDUN_ S "p 2�E Name: CRAIG CANTRELL
Addrests-:3 1- t z-r�T VSot kc,.-) Company: AMTEK AIR CONDITIONING
City: C>Y,-%"' Sof- Lwt..1&g- State:FL Address: 571 MERCANTILE PL#B-12
Zip Code: 34`iS.a. Fax: City: PORT ST.LUCIE State:FL
Phone No. L..3 l - 1014 L..,D Zip Cade: 34986 Fax:
E-Mail: Phone No. 772-801-3465
Fill in fee simple Title Holder on next page I If different E-Mail: amtekac@gmail.com
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.
SItPFI EMENTA►1_CONSTRUCTION LIEN CAW 1NF�JRMAT1taN
N� ,
a
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 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 OF FLORIDA STATE OF FLORIDA
COUNTY OF T L_Ue_A-e— COUNTY OF rbc f.'. C—
The forgoing instrument was acknowled ed before me The forgoing instrument was acknowledged before me
��'a
this� y of_����L .120by this4")�I20t by
of� � y
(Name of pers n cknowledging.) (Name of per cknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known � OR Produced Identification Personally Known 'V OR Produced Identification
Type of identification Produced Type of Identification Produced
Commission No. 111"""'� (S& ORAH RUSSELL ommission No. DEBC 5USSELL
Notary Public-State of Florid �a=�`�1°�-� Notary Public-State of Florida
° •c M Comm.Expires Nov 30,201 My; My Comm.Expires Nov 30,2018
" s"r' _ oec Commission#F Commission # FF 17963U
Revised 07/15/2014 'f°�flgl' Banded through National Notary Assn. rFg;,;; Bonded through National Notary Assn.
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