HomeMy WebLinkAboutBuilding Permit Application ALLOPLICABLE INFO.MUST BE COMPLETED FOR.APPUCATION'TO BE ACCEPT•E0
Date: tJ Permit Number.'
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential�.
PERMIT APPLICATION FOR: McChanical
PROPOSE D-IMPROVEMENT LOCATION:
Address:
Legal Description: 111
Property Tax ID#: 1 1�Q( - I!ro fDS- n_054- OCA -d Lot No. r
Site Plan Name: . Block Nc _47"s
Project Name: ,ne-1'{'E'
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION`OF WORK:
C51 . refl�ee"4_A �F 3�AJ f C� S� 4+1 C �u
CGS ham'
CONSTRUCTION' NFORMAT.ION
Additional work o be ertormed under this perms —check all that appy:
HVAC Gas Tank ❑Gas Piping _Shutters F�Windows/Doors
11 Electric 0 Plumbing Sprinklers L-, Generator I..loof
Total Sq.Ft of Construction: r5 LE 9 Sq.Ft.of First Floor:
Cost of Construction:$ `��J`�O- Utilities:[]Sewer Septic Building Height:
OWNER/LESSEE: �v + r CONTRACTOR:
Name Mcl rcap_ C 1� I�P�-r[� Name: CRAIG CANTRELL
Address: 84tDt42 (A) r fV_,r" Oln4 Company: AMTEK AIR CONDITIONING
city: c,>c+ P i ee'e P State:FL Address: 571 MERCANTILE PL#B-12
Zip Code:--.;413'1:;( Fax: City: PORT ST.LUCIE State:FL
Phone No. 352— 4914SQ 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@gmail.com
from the Owner listed above) State or County License. cac1816639
If value of construction Is S2S00 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CC+NSTRUCTIO:N LIEN LAW,INFORMATION
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 1 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 L .LCA e COUNTY OF S+_L_C _e
The for oing instrument was acknowled ed.before me The for oing instrument was acknowledged before me
this oh day of 20UW by this 'µday of 20 12by
0_60t• l gra► area
(Name of pe s n acknowledging) (Name of pWJon acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida
/ORPersonally Known Produced Identification Personally.Known ✓ubOR Produced Identification
Type of Identification Produced Type of Identification Produced
DEBORAtt@ SELL
Commission N ,+++���, D ?H RUSSELL '
�� Commission No. ,.""""��.,
Notary Public State of Florida r =ok ��. Notary Public State of Florida u,
Comm.Expires Nov 30,2018 ''_M Comm.Expires Nov 30,2018
-• r _ Y
.� Commission # FF 17 .�- ommis
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Revised 07/15 2' 14.4 p� jed lhrour,!'Nzn�nal Plulary Assn• 'Foy Foo-` Bonded through National Notary Assn.
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