HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q�s- V109,
Date: Permit Number: J
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
Address:
Legal Description: PORTOFINO SHORES -PHASE THREE-(PB 43-40) LOT 396 (OR 4067-205,207)
Property Tax ID #: 1312-503-0169-000-7 Lot No. 396
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
KW 10
TON 5
SEER 14
CO.NSTRiU,�C I±OIN +IINIF'OIRi t a GATI:OIN
Additional work to e _ e orme under this permit — check a apply:
11HVAC E] Gas Tank Gas Piping _ Shutters Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
I
Cost of Construction: $ 5750.00
S Ft. of First Floor: _
Utilities:[]Sewer OSeptic
Building Height:
O,W�NEIR%IJE`S�S{EiE;:'
CO!NTRAjC�TOiR?:
Name GREG STEENBURGH
Name: MARK A VINES
Address::5820 SPRING LAKE TERRACE
Company: AZTIL
City: FORT PIERCE State: FL
Zip Code. 34951 Fax:
Phone No. 772-201-0190
Address: 2540 S MILITARY TRAIL
City: WEST PALM BEACH State: FL
Zip Code: 33415 Fax:
Phone No. 561-433-2197
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: PERMITS@AZTILAC.COM
State or County License: CAC049253
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
S401IPiRUBM, hNTAL(COIN'STR'.UCTION 'LI'EN LAW LN'FO'RMATI,O'N1;
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: GREGSTEENBURGH Name: MARKAVINES
Address: Address: 5820 SPRING LAKE TERRACE
City: FORT PIERCE State: City: WEST PALM BEACH State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address: 2540 S MILITARY TRAIL
City:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 fir t inspection. If you intend to obtain financing, consult with lender or an attorney before
comme�e ng>iork or record
i�i�jg your Notice of Commencement,-
- 51�
e*
Signature of Owner esse Contractor as Agent for Owner
Signature of Contra or/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF PALM BEACH
COUNTY OF PALM BEACH
The f,o,r� oing instrument was acknowledged before me
The for oing instrument was acknowledged before me
this � day of M 0.y 20� by
thisa� day of K aM 20 19 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 Identificatio II
roduced
_
Pr uce
1
APAV Poe Notary Public State of Florida
a° Gifford
.d'Y?�o Notary Public State of Florida
S ature of �7#I S t S%18 Jz�l�i�z GG 147815
1021
Ira
of t r P bTi afe - in
�• y t ' ion GG 147815
of �° xpires
Olture
1 e
of 10 Expires 12/17/2021
C mission No. a
mission No. 11
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
i
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17