HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 0 � T
Date: I I�• , Permit NuEl�,P r" ,
nt
--- -- -- NOV 1 4 2019
Building Permit Applicatio
Planning and Development Services Permitting [department
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 St. L U C i e CO U n ty r FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial I en la
PERMIT APPLICATION FOR: .Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 159 SE LUCERO DRIVE
Legal Description: RIVER PARK UNIT 5
Property Tax ID#: 3419-540-0355-000-7 Lot No. 18
Site Plan Name: Block No. 54
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
KW 5
TON 2.5
SEER 14
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit-check a appy:
HVAC Ei Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 4275.00 Utilities:n Sewer Septic Building Height:
OWN ERAESSEE: ;' CONTRACTOR:
Name MAJ a Name: MARK A VINES
Address:� �- C:e ✓� Company: AZTIL
City: -T_ �>��-� �- , State: Address: 2540 S MILITARY TRAIL
Zip Code: 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:MARKAVINES
Address:159 SE LUCERO DRIVE 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.
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 nspection. If you intend to obtain financing, cot 'th lender or an attorney before
commen ' rk or recordingo tice of Commencementnsul
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 14 day of NOVEMBER 20� by this 14 day Of NOVEMBER ,204 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 Identification
Produ d Produced
(Signature of Nota W**,SStat ql:IQrjka,4ate of Florida (Signature of Notary ubF&,�xate 14K State of Florida
Analisa Whiting MJ9 � Analisa Whitin
Commission No. My Commi$SeapG 339912 Commission No. My CommU�@a�jG 339912a pires 05129120223 Expires 05))2__91204¢43
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17