HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 02-22-2017 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: Other
PROPOSED..IMPROVEMENT LOCATION: `
Address: 5163 N HWY Al #717 Ft. Pierce, FL 34951
Legal Description: OCEAN HARBOUR CONDOMINIUM D-UNIT 717 (OR 3859-2281)
Property Tax I D#: 1411-708-0031-000-4 Lot No.
Site Plan Name: Douglas J Clark Block No.
Project Name: Douglas J Clark
Setbacks Front Back: Right Side: Left Side:
DETAILED=DESCRIPTION•OF WORK:
Replace existing like for like split system (2 TON) TRANE Condenser 4TTR40241_1000A; TRANE Air
Handler TMM4A024S21 SA.W-1-th 5 Y Vj ReQ+-
CONSTRUCTION INFORMATION
i
Additional work toe e orme under this permit—check a appy:
HVAC ff Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric ❑ Plumbing Sprinklers E Generator D Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ 2,500.00 Utilities:Sewer Septic Building Height:
GINNER/LESSEE: CONTRACTOR: :,
Name Douglas J Clark Name: James E Dupuis
Address:239 Hidden Ln Company: Jimmy's AC&Refrigeration Inc.
City:• West Palm Beach State:FL Address: 46 43rd CT
Zip Code: 33413 Fax: City: Vero Beach State:FL
Phone No.561-358-2427 Zip Code: 32968 Fax: 772-299-3184
E-Mail:clarkfam88@gmail.com Phone No. 772-562-8353
Fill in fee simple Title Holder on next page(if different E-Mail: info@jimmysair.com
from the Owner listed above) State or County License: CAC18114821
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:
Address: Address:
City: State: City: State,
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: 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 thepermit 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 obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Gw�.wv ! tcivrZ.y F s
Si ature of Owner/Lessee/Contr for as Agent for Owner Signat a of Contractor/License Hol er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF t<e-r COUNTY OF �n �c�-� ��✓
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 'Fg_-birLgCLrS4 20 aby this day of 20 t7) by
7-e- "E- SA , (3 l v�E�r) :7- e5cefs e4 rim.
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Nota:2�OR
tate of Florida) (Signature of Notary Public-State of Florida)
Personally Known Produced Identification Personally Known�R Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FE— AS"3 RI(p Seal) fission No. Seal)
•``aJad'�% TERESA G.BUBEN �`N`�V PV�4, TERESA G.BUBEN
?�• ;�? Notary Public-sta e o :r ,°E Notary Public-State of Florida
Revised 07/15/2014 '` M Comm.Expires Jul 21,2018 _.• �•.:
y Nr as My Comm.Expires Jul 21,2018
Commission aY FF 143816 :9•fo«�d;; Commission N FF 143816
REVIEWS FRONT ONING SUPERVISOR PLANS VEGETATION SEA'TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS