HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �
Date: Jc✓\.?\,.. Permit Number: 19 O –_
111111/11111116
COUNTY ` RECEIVED
F R IDA
Building Permit Application MAR 2 7 2018
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County
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: 10701 S OCEAN!DRIVE UNIT 741
Legal Description: VENTURE OUT-SECTION C-LOT 142(OR2949-476)
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Property Tax ID#: 4511-805-0142-000-9 Lot No. 142
Site Plan Name: Block No.
Project Name: CAMPBELL
Setbacks Front Back: Right Side: Left Side:
iDIETAILED DESCRIPTION OF WORK:
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TON 2 �ov4 GT ver rJ �-
SEER 15
'OOINSTRiU CTI'O N INFORMATION:
Additional work to b_erformed under this permit–check all hat apply:
HVAC Gas Tank Gas Piping I _Shutters Q Windows/Doors
— n
ElElectric ❑ Plumbing ❑Sprinklers I I Generator _Roof Roof pitch
Total Sq. Ft of Construction: 627 S Ft.of First Floor:
Cost of Construction:$ 46 9 7.5.– Utilities: I Sewer 0 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name DAVID CAMPBELL Name: MARK A VINES
Address: 10701 S OCEAN DR#741 Company: AZTIL
City: JENSEN BEACH ; State: FL Address: 2540 S MILITARY TRAIL
Zip Code: 34957 Fax: City: WEST PALM BEACH State:FL
Phone No.780-717-0759 Zip Code: 33415 Fax:
E-Mail: Phone No. 561-433-2197
Fill in fee simple Title Hollder 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.
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SUIPPLE'MiEINTAL'CO,N;STRUCTION LIEN LAW INsFO'R,MIAITI,O;N9 '
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: DAVID CAMPBELL Name:MARKAVINES j
Address:10701 S OCEAN DRIVE UNIT 741 Address: 10701 S OCEAN DR#741
City: JENSEN BEACH State: City: WEST PALM BEACH State:
Zip: Phone Zip: Phone:
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FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address:2540 S MILITARY TRAIL Address: 1
City: City:
Zip: Phone: Zip: Phone: I
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 inspection. If you intend to obtain financing, consult with lender or an attorney before
commen ' g work or recording your Notice of Commencemen
A, / �
Signature of Owner/Lessee/Contractor as Agent for Owner Signature o Contractor/License-Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALM BEACH COUNTY OF PALM BEACH
The forgoing inst�m^ent was�cknowledged before me The for oing instrument wa acknowledged before me
this2l day of r ►1 a r"h ,2011 by thisa1 day of rVt rC ,2011 by II
MARK A VINES MARK A VINES
Name of pe on making statement Name of pers n making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced _ / Produc-: /
l...:. .,. _., • ''' ..,'Ild.
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(Signa re of .ry••. : .: gn.tur o otary - tate of Florida)
etY°ft Notary Public State of Florida Y r
C missi. No ' 4' i r, John Ed*KilgGifford 7/ No. =off ``� Notary Pyy�ig$t�+to of Florida
/q < y Commission GG 147815 i : John Edb7aittGifford
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-0,,,,,n, Expires 12/17/2021 0,,-- z My Commission GG 147815
jEo�fof Expires 12!1712021
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REVIEWS FRONTI ZONING SUPE•VISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE .
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
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