HomeMy WebLinkAboutREGENCY PERMIT APP ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/13/17 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 X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end Of line
PROPOSED IMPROVEMENT LOCATION:
Address: 8600 S OCEAN DRIVE:, JENSEN BEACH, FL 34957
Legal Description:
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Flight Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REPLACING EXSISTING COMMERCIAL AMERICAN STANDARD 12.5 TON PACKAGE AC
SYSTEM. TSH150F3ROA0000
CONSTRUCTION INFORMATION:
Additional work to ff
orme un er t is permit—c ec a app y:
✓ HVAC CI Gas Pig
Gas Tank Shutters Q Windows/boors
Piping
Electric 0 Plumbing Sprinklers 0 Generator O Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 25,000.00 Utilities Sewer F]Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name REGENCY SOUTH @ISLAND DUNES II Name: LOUIS R WINDT
Address:8600 S OCEAN DRIVE Company: LOUIE'S AC SERVICE INC
City: JENSEN BEACH State:FL Address: 6931 HERITAGE DRIVE
Zip Code: 34957 Fax: City: PORT ST LUCIE State:FL
Phone No.772-229-0311 Zip Code: 34952 Fax: 772-429-5267
E-Mail: Phone No. 772-335-7071
Fill in fee simple Title Holder on next page(if different E-Mail: LOUIES—AC@YAHOO_COM
from the Owner listed above) State or County License: CACO27371
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: x 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 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 obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
5
,,knatti're of Owner/Lessee/Contractor as Agent for Owner Wnate6 of Contractor/License Holder
STATE OF FLORIDA- STATE OF FLORIDA
COUNTY OF —'' _....__ COUNTY OF '`- l_
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of y 20 fu- by thisdayaf_ ;, `i 20 _by
Y
SAY". AMY K.PEARSON
Al K.PEARSON
Commission#FF 235217 ' = Commi
CAIIJIM
(Name of person acknowledg ', y t fi" B-dedThmTWFwx nureoaeeooae�io, Name of person acknowledgi R - e Mpereh May 2752wc.goo o,s
(Si nature b",.,ptarFlorida ----g y Public-State of Florida i {Signature 'f Natary Public-State of Florida}
Personally Known ~J OR Produced Identification Personally Known L OR Produced Identification
Type of Identification Produced Type of Identification Produced
1 s- � sa ij' Seal Commission No {Sea!} Commission No. (Seal)
Revised 07/15/201.4
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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DATE
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