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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«,.. ��
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'••'.,Fo�noP: EXPIRES e�cgber 17. 2017
Com 'ssio No. I
(407)398-0153 FloridallotaryService.
Florida otaryServicecom
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Rev. 912J17