HomeMy WebLinkAboutPermit Application-Surfside GrilleAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
S'�C LLL.:y, (ZLL!
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial X
PERMIT APPLICATION FOR: commerciala 5 R
mini-s
PROPOSED IMPROVEMENT LOCATION:'
l�t
Residential
address: 10545 South Ocean- Drive
Property Tax ID #: 4511,500-0005-000.,1 lot No. 2
Site Plan Name: BEACH CLUB COLONY -SECTION ONE NWLY 49.60 FT OF LOT Block No.
Project Name, Surfside Bar and Grill
DETAILED DESCRIPTION OF WORK:
New install of commerical mini -split system Daiken 4MXS36RMVJU=GO2751 0 FTXS24LVJU=EO39503, FTXS18LVJU=E092722
AHR1# 201851579 17.7 Seer
New Electrical Meter
Second Electrical Meter.
...
CONSTRUCTION INFORMATION0
:
Additional work to be
performed under
this permit — check all
that apply:
X Mechanical
� Gas Tank
_Gas Piping
� Shutters
Electric
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 91131
_Sprinklers
Generator
Windows/Doors Pond
Roof Pitch
Sq. Ft. of First Floor: _
Utilities: Sewer � Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name -,Tammy L Simoneau- Surfside Grille & Pizzaria Narne:_Adam Emanuel
Address: 10545 South Ocean Drive Company: Arnold's Air Conditioning of South Floric
City: Jensen Beach State Address: 1413 SE Conference Cr
Zip Code: 34957 Fax: City: Stuart State: Fl.
Phone No. (772) 349-4070 zip code: 34997 Fax:
E-mail: simoneaut((!,)yahoo.com Phone No 561 P-51 5-5527
Fill in fee simple Title Holder on next page ( if different E-Maii adam0amoldsairconditioning. net
from the Owner listed above) State or County license CAC 1814146
If value
of
construction is
2500 or more, a RECORDED Notice of Commencement is required.
If value
of
HAVC is $7,500
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:
OWNER/ CONTRACTOR AFFIE)VIT: 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 Count makes no representafiion that is granting a permit will authorize the permit holder to build the subject structure
which is in conflici with and 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
ire 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lurie County and posted an --the jobsite before the first inspection., If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording Notice of Commencement.
:�.��-- 'J
Signatp-re..9f.Own4'[U�
ssee/Gcint�-actor as Agent for Owner Signature of Contrktor/-Lic'ense-folder
STATE OF FLORIDA � Of STATE OF FLORIDA (�
COUNTY OF � � COUNTY OF.
Swo 'to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
Physical Preseq�e or Online tarixation �/Physical Present or Online Notarization
this �day of �. k ' 20A9 by this 0 day of 26aL 20M4y
a ILA
Name of person making statement. Name of person making statement.
&/0"" aR Produced identification PersonallY Known- Personally Known.�OR Produced Identification
Type of Identification Type of identification
Produced Produced
A Jr t
(Signature of Notary Public- StaDte��� i(Signature of Notary Public- State of Florida }
orl
Commission No mmo# 8977 Commission No.
a►�
E x ns June 26, 2023
y d
�,,ond A#0A"W11
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATI�� �EA T�RVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
v.