HomeMy WebLinkAboutBuilding Permit Application ALL APPLIC_ABBLLEINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date's O��Z 18 to '�' Permit Number: 1� Q
RECEIVED
Building Permit Application OCT 0 3 2018
Planning and Development Services
Building and Code Regulation Division 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 IM'P'ROVEMENT LOCATION:
Address: 15041 AGUI4A , FORT PIERCE, 34951 (MOBILE HOME PARK)
Legal Description. SPANISH LAKES FAIRWAYS
Property Tax ID#: 1306-111-0001-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
KW 1
TON
SEER 14
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check all appy:
HVAC Gas Tank []Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 4800.00 UtilitiesInSewer.0Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name RUSSELL MOSER Name: MARK A VINES
Address: 15041 AGUILLA AVENUE Company: AZTIL
City: FT. PIERCE State: FL Address: 2540 S MILITARY TRAIL
Zip Code: 34951 Fax: City: WEST PALM BEACH State:FL
Phone No.772-359-4644 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.
`SIUIPiPL`EIM,lEiNT/AILCONSTRUCTION LIEN LAW INFORMATION:'
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:RUSSELL MOSER Name:MARK AVINES
Address: 16041 AGUILLA AVENUE,FORT PIERCE,34951 (MOBILE HOME PARK) Address: 15041 AGUILLA AVENUE
City: FT.PIERCE 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 roperty. A Notice of Commencement must be recorded and posted on the jobsite
before the first' ec on. If you intend to obtain financing, consult with lender or an attorney before
commencin ork o recording our Notice of Commencement
Signature of Owner/Lessee/Con ractor as Agent for Owner Signature of Contractor/Lice se Holder
STATE OF FLORIDA STATE OF FLORIDA
CO U NTY O F PALM BEACH CO U NTY OF PALM BEACH
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 26 day of SEPTEMBER 20L by this 26 day of SEPTEMBER 20jJ 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
Pr ce Produce
(Sign ure ota P.�i S'tat�13P Aid` ?rg pifford (Signatu of y c a e o
at..- , < My Commission GG 147815 h r Gifford
9?oF Expires 12/ 120 1 < ommisslon GG 147815
omm' on No. Sea Com issio No. 'yt Expires 12/�S@A�
REVIEWS FRONT ZONING SUPERVIS R PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVI REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17