HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE 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) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 3264 PERIGRINE FALCON DRIVE
Legal Description: FAIRWAYS AT SAVANNA CLUB REPLAT NO 1 (PB 57-40) BLK 66 LOT 17 (OR 3711-904)
Property Tax ID #: 3424-800-0031-000-3
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
A/C CHANGE OUT
4 TON
14 SEER
Right Side: Left Side:
Lot No. 17
Block No. 66
CONSTRUCTION INFORMATION:
CONTRACTOR:
Name JOHN & JOANNE BOND
Name: MARK A VINES
Additional work to b rtormed un er t is permit — c ec
a
appy:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
HVAC Gas Tank
❑Gas Piping_
Shutters
E]Windows/Doors
11 Electric Plumbing
Sprinklers
E] Generator
Roof Roof pitch
Total Sq. Ft of Construction: 1,307
S .
Ft. of First Floor:
Cost of Construction: $ 4975.00
Utilities:Sewer
Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name JOHN & JOANNE BOND
Name: MARK A VINES
Address: 3264 PERIGRINE FALCON DRIVE
City: PORT ST. LUCIE State: _
Zip Code: 34952 Fax:
Phone No. 772-248-6961
E -Mail:
Company: AZTIL
Address: 2540 S MILITARY TRAIL
City: WEST PALM BEACH State: FL
Zip Code: 33415 Fax:
Phone No. 561-433-2197
E -Mail: PERMITS@AZTILAC.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
SIAM bP Cbunty LICgf' ! GAG04922
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
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:
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 o/recording your Notice of Commencement.
0
Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF PALM BEACH
The forgoing instrument was acknowledged before me
this 29 day of 3.74 % 20 (Zby
MARK A VINES -1-
(Name
(Name of person acknowledging )
(Signature b�✓tary Public- Stade of Florida )
Personally Kn n xx OR Produced Identification
Type of Identification Produced
Signature of C'6ntractor/License Holder
STATE OF FLORIDA
COUNTY OF PALM BEACH
The forgoing instrument was acknowledged before me
this 28 day of JULY , 20 1 7 by
MARK A VINES
(Name of person
(Signa u of Notary Pub ic- St to f Florida )
Personally Known xx OR Produced Identification
Type of Identification Produced
=o���' °o�._ JOHN � VJIARD GIFFORD
Commission No. r My c o 1 ipN #FF077427 Commission No.
a:
EXPIRES December 17, 2017
(407) 398 0153
Revised 07/15/20
�
JOHN RD GIFFORD
�^ MY COMMISSION #FF077427
,F�d?;._• EXPIRES December 17 2017
398-0153 FlondaNMUYSeMce con'
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