HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �' • 1 Permit Number:
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Building Permit Application AUG 14 2019
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
li
SPR®P®SE® I�MPaft'OEIUIENTL�O�C�A®'N _=3 ° T -
Address: 8200 FORT PIERCE BLVD, FORT PIERCE, FL 34849
Legal Description. LAKEWOOD PARK-UNIT 8-BLK 93 LOT 12(MAP 12/02N)(OR 3480-242)
Property Tax ID#. 1301-608-0141-000-3 Lot No.
Site Plan Name: Block No. s
Project Name:
Setbacks Front Back: Right Side: Left Side:
DET�A�I�LED ®IESCRIjF�TION ®R1WOR
KW 7
TON 3 S\tc#q GT
SEER 14
e°: :. �a 1.c�. *": :"`•.s;�"^"',T'�"�TM'^.�,y* 't'�"- #° "�'�°' r-�+�.,�s^,� � --may. �, .
Additiona wor to e e Orme under this permit—c ec a appy:
❑HVAC Gas Tank Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing U Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S�Ftj of First Floor:
Cost of Construction:$ 4475.00 Utilities: nSewer 0Septic Building Height:
j®�WN!ER%LE-�SSEaE NOTRACT®�R.
Name 1JAJoLA - L (1aL Name: MARK A VINES
Address: ZOO/ 1PULIL 4Q Company: AZTIL
City: &&!L A 60&0 State: NL Address: 2540 S MILITARY TRAIL
Zip Code: b 2 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.
S�UPC®;N�S1R(U�CTI,ONkL`IENLA�WaI(�FOR'MIA1 ®;I E „�
DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:MARKAVINES
Address:8200 FORT PIERCE BLVD,FORT PIERCE,FL 34849 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 the first insp 'on. If you intend to obtain financing,consult with lender or an torney before
commencing wo or ecordin our "e e of Commencemen
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License 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 9 day of AUGUST ,20— by this 9 day of AucusT ,20_ by
MARK A VINES MARK A VINES
Name of person making statement Name of person making statement
Personally Known 'f' i Personally Known OR Produced Identification
Type of IdentificatioType of Identification
Notary Public State of Florida
Pr ed M A i hiting Prod ANotary Public ng of Florida
+� My Commission GG 339912 a Isa g
olpw Expires 05/29/2023 < My Commission GG 339912
OF Expires 05/29/2023
(Signatur o otary Public-State of Florida (Signature of N to ublic-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW- REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17