HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
Building Permit Application JAN 16 2018
Planning and Development Services
Building and Code Regulation Division f ST. Lucie County, Permitting
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: 8486 LABELIA COURT
Legal Description. SAVANNA CLUB PLAT THREE BLK 21 LOT 25 )OR 3178-686)
Property Tax ID#. 3425-703-0071-000-0 Lot No.25
Site Plan Name: Block No. 21
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
3 TON
14 SEER pO4T �(w
10 KW
CONSTRUCTION INFORMATION-
Additional work toa er orme under this permit—check a apply:
HVAC E] Gas Tank []Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers E]Generator E] Roof Roof pitch
Total Sq. Ft of Construction: 1,122 S Ft. of First Floor:
Cost of Construction:$ 4250.00 Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name RITA FASULO Name: MARK A VINES
Address:8486 LABELIA COURT Company: AZTIL
City: PORT ST LUCIE State:_ Address: 2540 S MILITARY TRAIL
Zip Code: 34925 Fax: City: WEST PALM BEACH State:FL
Phone No.772-879-9915 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: RITAFASULO Name:MARKAVINES
Address: 8486 LABELIA COURT Address: 8486 LABELIA 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 recorded and posted on the jobsite
before the first iosqction. If you intend to obtain financing, cons ith lender or an attorney before
commencin or or recordi-ng your No ice of Commenceme
/A�* e5�e
Signature of Owner Lessee/Contra or as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALMBEACH COUNTY OF PALMBEACH
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 16 day of JANUARY 20_ by this 16 day of JANUARY ,20_ by
MARK A VINES MARK A VINES
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 Produced
' n ure of ota � (Si ture of No r
Notary Public State of Florida Notary Public State of Florida
rd
mmi Ion N John Edwggt gU ord Commissi No. John Edward C3i�fo14
My Commiasion G 147815 y Comm, 147815
�Vd Expires 12117/2021 OF M1 Expires 12117/2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17