HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �aT� Permit Number:�1 1 a�dsd S
•
Building Permit Application 0 � 75_�- a
Planning and Development Services
i
Building and Code Regulation Division DEC 19 2011 `
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
B`!�........
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 8504 MARLBERRY COURT
Legal Description. SAVANNA CLUB PLAT THREE BLK 23 LOT 38(OR 1348-200)
Property Tax ID#: 3425-703-0122-000-3 Lot No. 38
Site Plan Name: Block No. 23
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
KW 7
14 SEER
4 TONS
CONSTRUCTION INFORMATION:
Additional work toe er orme under this permit—check a appy:
HVAC E] Gas Tank Gas Piping _Shutters Windows/Doors
11 Electric ❑ Plumbing ❑Sprinklers E]Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $��00 .t d Utilities:cnSewerOSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name MATTHEW PALMER Name: MARK A VINES
Address:8504 MARLBERRY COURT Company: AZTIL
City: PORT ST LUCIE State:_ Address: 2540 S MILITARY TRAIL
Zip Code: 34952 Fax: City: WEST PALM BEACH State.FL
Phone No.772-336-0637 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: MATTHEWPALMER Name: MARKAVINES
Address: 8504 MARLBERRY COURT Address: 8504 MARLBERRY COURT
City: PORT ST LUCIE State: City: WEST PALM BEACH State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: 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 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 re ed and posted on the jobsite
before t st inspecti . If you intend to obtain financing, consult I der or an attorney before
com nc' work ortKording your Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA � / STATE OF FLORIDA
COUNTY OF 0"Im r3-ek COUNTY OF PALMBEACH
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 1.6 day of D!. r 201-7 by this 18 day of DECEMBER 2017 by
rnet f k- MARKAVINES
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 Iden tificati
Produce Produce state of Honda
a tate of FIonda dward Gifford
ord n y Com ion GG 147815
G y Commission 147815 Expires 12/ 2021
M1
Expires 1211 1 sw
gnatur Not Signat a of No i State rida)
/ missi o. (Se a+ Co mission No (Seal)
REVIEWS FRONT ZONING SUPERWS(OR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW , REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17