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HomeMy WebLinkAboutBuilding Permit ApplicationI ALL 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: 3119 SCARLET TANAGER COURT Legal Description: EAGLE'S RETREAT AT SAVANNA CLUB Property Tax ID #: 3424-702-0015-000-4 Site Plan Name: MCPHILLIPS Project Name: Setbacks Front Back: DETAILED DESCRIPTION OF WORK: 4 TON 14 SEER 10 KW Right Side: Left Side: Lot No. 5 Block No. 58 CONSTRUCTION INFORMATION: . Name WILLIAM MCPHILLIPS Address: 3119 SCARLET TANAGER COURT Name: MARK A VINES Additional work to be nertormed under this permit— check HVAC Gas Tank E]Gas Piping all that appy: 1:1_ Shutters ❑ Windows/Doors Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E -Mail: PERMITS@AZTILAC.COM State or County License: CAC049253 11 Electric ❑ Plumbing Sprinklers 11 Generator E]Roof Roof pitch Total Sq. Ft of Construction: 1,988 S Ft. of First Floor: Cost of Construction: $ 4650.00 Utilities:Sewer OSeptic Building Height: OWNERAESSEE: CONTRACTOR: Name WILLIAM MCPHILLIPS Address: 3119 SCARLET TANAGER COURT Name: MARK A VINES Company: AZTIL City: SAINT LUCIE COUNTY State: _ Zip Code: 34952 Fax: Phone No. 772-340-2069 Address: 2540 S MILITARY TRAIL City: WEST PALM BEACH State: FL Zip Code: 33415 Fax: Phone No. 561-433-2107 E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E -Mail: PERMITS@AZTILAC.COM State or County License: CAC049253 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIO t, DESIGNER/ENGINEER: _ Not Applicable Name: WILLIAM MCPHILLIPS MORTGAGE COMPANY: _ Not Applicable Name:MARKAVINES Address: 3119 SCARLET TANAGER COURT Address: 3119 SCARLET TANAGER COURT City: WEST PALM BEACH State: Zip: Phone: City: SAINT LUCIE COUNTY State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: 2540 S MILITARY TRAIL 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. Rev. 912J17 Signature of Owner/ L ssee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF PALM BEACH COUNTY OF PALMBEACH The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 16 day of OCTOBER 20 1 *'1 by this 16 day of OCTOBER 20_ft by MARK A VINE MARK A VINES Name of person making statement Name of person making statement Personally Known x OR Produced Identification Personally Known x OR Produced Identification Type of Identification Type of Identification Produced Produce (Si ture o a I' SyY1te o pry My pM SION #1717077427 gnat o y Ra'li to 1 'SION stFF077427 " oa'EXPIAE tuber 17. 2017 Co ssion �o«,.. �� o '••'.,Fo�noP: EXPIRES e�cgber 17. 2017 Com 'ssio No. I (407)398-0153 FloridallotaryService. Florida otaryServicecom REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 912J17