HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date:\Q,\ Permit Number: k1 1a' C�50-1
Building Permit Application
Planning and Development Services DEC 19 2011
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982x,
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resid6ntial X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 3048 SALTBUSH LANE, PORT ST LUCIE
Legal Description. SAVANNA CLUB-PLAT TWO-BLK 32 LOT 9(OR3719-2944;3725-803)
Property Tax ID#: 3425-702-0234-000-8 Lot No.9
Site Plan Name: Block No. 32
Project Name:
Setbacks Front _ Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
3.5 TON
7 KW
12 SEER
CONSTRUCTION INFORMATION:
Additional work to be rtormed under this permit—check all appy:
HVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 4500.00 Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name JOYCE WELTON Name: MARK A VINES
Address:3048 SALTBUSH LANE Company: AZTIL
City: PORT ST LUCIE State:_ Address: 2540 S MILITARY TRAIL
Zip Code: 34952 Fax: City: WEST PALM BEACH State:FL
Phone No.772-342-2625 Zip Code: 33415 Fax:
E-Mail: Phone No. 561-433-2197
Fill in fee simple Title Holder on next page(if different E-Mail: PERMITS@AZTILAC.COM
from the Owner listed above) State or County License: CAC049253
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION 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 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 th inspection. If you intend to obtain financing, consult with lender or an attorney before
comm cin work or recordiM your Notice of Commencement.
Signature of wner/Lessee/Contractor as Agent for Owner Signature of ontractor/License Holder
STATE OF FLORIDA Q
STATE OF FLORIDA
COUNTY OF I COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of �,,,,/�� ,20� by this 1 day of �sC�.v�.J�.!' 20,] by
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produc +►r Notary Public State of Florida
to of Flori ward Gifford
eb Gifford fission GG 147815
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mmission GG 147815
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1712021
natu of t (Si atur ary Publ orida)
Co ssio o. (Seal) o issi No. (Seal)
REVIEWS FRONT ZONING SUPE ISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17