HomeMy WebLinkAboutBuiding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10 a5 I Permit Number: t 81° — 0 gee
COUNTY
F 1:. O 11110
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
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: 10725 S OCEAN DRIVE UNIT 26
Legal Description: HOLIDAY OUT AT ST LUCIE BLK D LOT 20 AND EQUAL PRO-RATA INTEREST IN COMMON
ELEMENTS(OR 3480-241: 3930-2962)
Property Tax ID#: 4511-501-0137-000-8 Lot No. 20
Site Plan Name: Block No. D
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
KW10
TON 2.5
SEER 14
CONSTRUCTION INFOIRMATION
Additional work to be pertormed under this permit–check all;hat apply:
HVAC _Gas Tank nGas Piping _Shutters ❑Windows/Doors
77
['Electric ❑ Plumbing Sprinklers I J Generator ❑ Roof Roof pitch
ri
Total Sq. Ft of Construction: S . Ft. of First Floor:
6385.00
Cost of Construction:$ Utilities: _Sewer Septic Building Height: .I
OWNER/LESSEE: CONTRACTOR:
Name ROSEMARY FARROW Name: MARK A VINES iI
Address: P.O. BOX 10065 Company: AZTIL
City: NEWBURG State:10 Address: 2540 S MILITARY TRAIL Ij
Zip Code: 12552 Fax: City: WEST PALM BEACH State:F;L
Phone No. 914-213-0852 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.
it
S°,UIPPLE.MIENTAL'CON'STR'UCTION LIEN LAW INFORMATION,:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: ROSEMARY FARROW Name:MARK A VINES
Address:10725 S OCEAN DRIVE UNIT 26 Address: P.O.BOX 10065 11
City: NEWBURG State: City: WEST PALM BEACH State: II
Zip: Phone Zip: Phone:
II
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: Name: 11
Address:2540 S MILITARY TRAIL Address:
City: City: II
Zip: Phone: Zip: Phone: 1t
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 f• nspection. If.you intend to obtain financing, consult ''lender or an attor. -y before
commen • g ork or recording, our Notice of Commencement. `
ng
Signature of 0 ner/ see/Con a or as Agent for Owner Signature of Contractor/I:cense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALM BEACH COUNTY OF PALM BEACH
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 22 day of OCTOBER. ,20 1g by this 22 day of OCTOBER ,201iit by
MARK A VINES MARK A VINES
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Kno OR Produced Identification
Type of Ident'fication Type of Identific tion
oduced I,k •roduced
`� ate'"W Notary Public State of Florida /
P\
\.. of
`z; John Edward Gifford �� , 1�i
11
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(Signa r of Not: ,`\ aat1r�5`ifnlpl'2H9�r2top GG 147615 021 (Sig ure of of a 9.,";..., d Gifford I .
a %.. i My Commission GG 1476515
Commission No. Comm .Ion No. o•a Expires 1-Peea 1
11
1
I
I
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17