HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED a(
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (7,72)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT11APPLICATION FOR: Mechanical
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,PIROIPO'SED IMiPiROVE,MiE1NT iLOCATJOK.
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Address: 7,679 WEXFORD WAY,
Legal Description: RESERVE PLANTATION PHASE 1 LOT 20(OR 225-2607)
Property Tax I D#: 3321-801-0020-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
mm
'PETALLED f CRI�PTItO'N',QF WOiRK s
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KW 5
TON 1.5
SEER 16
+C IN'STRUCT'ION :IIN F`OR! ,ATION
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Additional work to be nertormed under this permit—check all apply:
EIHVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers 11 Generator E] Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor.:
Cost of Construction:$ 3�(�1 Utilities..
Septic Building Height:
OU1%jN,E'R/LE'SSEE;; CONTRACTOR:,
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Name C,q(Z110lt, 5 . W 1_ Name: MARKAVINES
Address: = Company: AZTIL
City: '( s' LU C# State:r-L+ Address: 2540 S MILITARY TRAIL
Zip Code: ILdg 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.CO1Vl
from the.Owner listed 'above) State or County License: CAC049253
If value of,ionstruction is$2500 or more,a RECORDED Notice of Commencement is required.
SiUPPLEM°EiNTA "CO.NSTRUCTION,LIEN'LAW I'NFQR'M'AiTI;QN
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DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:MARKAVINES
Address:7679 WEXFORD WAY Address:
City: i State: City: WEST PALM BEACH State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: —Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Ad d ress,:2540 S MILITARY TRAIL Address:
City: City:
Zip: Phone: Zip: Phone:
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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 ob ain financing, co suit with lender or an attorney'before
commencin ork or recordiAg your Notic of Commencem t
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Signature of ner/Lessee/Contractor as Agent for Owner Signature of Contract /License Holder
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STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALM BEACH COUNTY OF PALM BEACH
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The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 13 Jday of —45&,vta yy%b..e-- ,20 I by this 13 day of SEPTEMBER 20 Iq 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
JA,4A1
Type of Identification Type of Identification
Produced4 Produced ^�
Signature of Nota Ig ature o Nota d�E1d141!
Notary Pubb{{�St to of Florida �OW N Notary Public State of Florida
Commission No +F allsaVldl�igd� Commission No. - . Analisa WhitO�
i My Commission GG 339912 y Comm' ion G 339912
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of Expires 05/2912023 awd�' Expires 05/29/2023
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER, REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE I
COMPLETED
Rev.8/2/17