HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: '► 3 l (t% Permit Number:
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
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 21 Iberia Lane 1� /� ii
Legal Description: _JL7Ctf�t�1 Lakas l�Df� Wl I c�_ Mob) le Rut'Y-e—
Property Tax ID #: 1406-333-0016-000-7
Site Plan Name:
Project Name: Barbara Fairley
Setbacks Front Back: X
DETAILED DESCRIPTION OF WORK:
A C ff)6 )�c ftt+ lCi
pcl -% - SP1, 143 ./4q I
Right Side: X Left Side:
Lot No._
Block No.
iaitionai worK to De DerTorrnecl
IiJHVAC Gas Tank
under tnis permit - cnecK allapply:
E]Gas Piping
Name Barbara Fairley
Shutters
COUNTY
F
L O R I D A
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
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 21 Iberia Lane 1� /� ii
Legal Description: _JL7Ctf�t�1 Lakas l�Df� Wl I c�_ Mob) le Rut'Y-e—
Property Tax ID #: 1406-333-0016-000-7
Site Plan Name:
Project Name: Barbara Fairley
Setbacks Front Back: X
DETAILED DESCRIPTION OF WORK:
A C ff)6 )�c ftt+ lCi
pcl -% - SP1, 143 ./4q I
Right Side: X Left Side:
Lot No._
Block No.
iaitionai worK to De DerTorrnecl
IiJHVAC Gas Tank
under tnis permit - cnecK allapply:
E]Gas Piping
Name Barbara Fairley
Shutters
Q Windows/Doors
Company: Aztil Inc.
City: Port Saint Lucie State: FL
Zip Code: 34953 Fax:
Phone No.772-398-0274
_
City: West Palm Beach State: FL
Zip Code: 33415 Fax: 561-434-0018
Phone No. 561-433-2197
E -Mail: —
11 Electric Plumbing
Sprinklers
1:1
Generator
11 Roof
Total Sq. Ft of Construction: nn
Cost of Construction: $
54`/DG,
S Ft. of First Floor: _
Utilities: Sewer El Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Barbara Fairley
Name: Mark Vines
Address: 21 Iberia Lane
Company: Aztil Inc.
City: Port Saint Lucie State: FL
Zip Code: 34953 Fax:
Phone No.772-398-0274
Address: 2540 S Military Trail
City: West Palm Beach State: FL
Zip Code: 33415 Fax: 561-434-0018
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone..
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 firs ' spection. If you intend to obtain financing, consult with lender or an attorney before
commenciwr'gwaft or recording your Notice of Commencement.-----..
_ Signature of Olwner/(Cessee/Agent
STATE OF FLORIDA -3_ II -Q �
COUNTY OF CSI m UL.1 tI
The f r oing instru ent was acknowledged before me
this day of ' ' 20 [(�y
1aA'k�►CS
(Name of person acknowledging )
11 ''ll
(Signature of Notary Public- State lorida )
Personally Known OR Produced Identi
Type of Identification Pro �;� �ldriouez
Commission No.
Revised 07/15/2014
re of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF Palm Beach
The forgoing instrument was acknowledged before me
this 23 day of March 20 /40—, by
�11ay k �� ► res
(Name of person acknowledging )
(Signature of Notary Public- State F rida )
Personally Known x OR Produced Identification
Type of Identification Produ _
Notary Public - State of Florida
��i�tssion#FF917447 Commission No.
E:VIGS 10 -Sep -19
NM�,Public - State of Florida
Commission#FF 917447
Expires 10 -Sep -19
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