HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:m—5 Permit Number: J O
_ RECEIVED
Building Permit Application OCT 0 6 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, PQrmitting
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: 4105 SMOKEY PINES COURT
Legal Description: HOLIDAY PINES
Property Tax ID#: 1313-502-0105-000-1 Lot No. 528
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
KW 7.5
TON 4 �L
SEER 16
CONSTRUCTION INFO'R'MATION:
Additional work toe nertormed under tispermit—check all appy:
HVAC Gas Tank []Gas Piping _Shutters D Windows/Doors
11 Electric 0 Plumbing Sprinklers ElGenerator El Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 6300.00 UtilitiesSewer F]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name - /_ I-c-0 ICY'0(f/NAqu) Name: MARK A VINES
Address: Y11'%J cx,-7 &hi(ff Company: AZTIL
City: ice?- P.L71,C-64 "State:_ Address: 2540,S MILITARY TRAIL
Zip Code:_3�fV Fax: City: WEST PALM BEACH State:FL
Phone No. 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.
.SIUIP:PLIEIMiE N T/AIL'CO N STR'U'CTI O N LIEN LAW l�N!FOIR MIA\TI;O NI',
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:MARK AVINES
Address: 4105 SMOKEY PINES COURT Address:
City: 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 th first inspection. If you intend to obtain financing, consult with lender or an attorney before
comm c' work orxiaording your Notice of Commencement.
Si ature of Owner/ essee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALM BEACH COUNTY OF PALMBEACH
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 3 day of OCTOBER 20 JY by this 3 day of OCTOBER 120 12' by
MARK A VINES MARK A VINES
Name of person making statement Name of person making statement
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signat of No �14cw�tatle r¢I i late of Florida i ature o o ry Sytte 815!191 0#4 State of Florida
John EdwaQifford John Edward Gifford
` y Commis ion G 147815
Co missio o "► ` My Ces 2� G 1478 Comm si- No. Tt �' Expires 121 1 p
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17