HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5`aa1 �� Permit Number: 1AvwF - y�
Lon
EIVED
Building Permit ApplicatPlanning and Development Services 2 3 2018Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ounty F0rf,,,,vng
Phone: (772)462-1553 Fax: (772)462-1578 Commercial ntial X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 207 E ARBOR AVE
Legal Description: RIVER PARK
Property Tax ID#: 3419-501-0019-000-9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
2.5 TON
7 KW
14 SEER
CONSTRUCTION INFORMATION:
Additional work to bertormed under this permit—check a appy:
HVAC Gas Tank E]Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 4000.00 Utilities:Sewer 0 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name ELLA SCHWARTZ Name: MARK A VINES
Address:207 E ARBOR AVE Company: AZTIL
City: PORT ST LUCIE State:_ Address: 2540 S MILITARY TRAIL
Zip Code: 34952 Fax: City: WEST PALM BEACH State: FL
Phone No.772-324-0094 Zip Code: 34952 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:ELLASCHWARTZ Name:MARK AVINES
Address: 207E ARBOR AVE Address: 207E ARBOR AVE
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 4st inspection. If you intend to obtain financing, consult with lender or an attorney before
comme i work or recording our Notice of Commenceme
Signature of wner essee/Contractor as Agent for Owner Signature of Contractor/License older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALMBEACH COUNTY OF PALM BEACH
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 21 day of MAY 20by this 21 day of MAY 20(7 11 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 7 Type of Identification
Produce Produced
(Si ature eJo tate o o ign of Notary P I - tat of Ion ic State of Florida
1% My Commission GG 147aP , John Edward Gifford
Commission o. �►..nd' Expires 1��� Co mission No My Co GG 147615
Of Expires`12117/2021
EVI S FR ZONING SUPER OR PLZS/ VEGETATION SEA TURTLE MANGROVE
NTER REVIEW RWfEW REVIEW REVIEW REVIEW REVIEW
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v. 8/2/17