HomeMy WebLinkAboutBuilding Permit Application 07/29/2015 WED 15: 42 FAX 12001/004
ADateLL E INFO oM ST�COMPLETED FOR APPLICATION TO BE ACCEPTED
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Building Permit Application
Planning and DevelopmentServices
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: Mechanical
Address: 5163 5163 N. HWY Al #81j?, FORT PIERCE, FL 34949
Legal Description: OCEAN HARBOUR CONDOMINIUM D- UNIT 816
Property Tax ID#: 1411-708-01Q�&000- Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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A/C CHANGE OUT LIKE FOR LIKE EXACT SIZE REPLACEMENT. 2.5 TON TRANE STRAIGHT
COOL 4TTR4030L/TMM5AOB3OM21 W/ 8KW HEAT
Additional work to benertormed under tis permit—check all fJ appy:
E1HVAC Gas Tank E]Gas Piping _Shutters Q Windows/Doors
11 Electric ❑Plumbing Sprinklers E Generator F] Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 4354.00 Utilities: LJ Sewer Septic Building Height:
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NameTHOMAS REBIK Name: ROBERT BROWN
Address:5163 N.A1A#816 Company: SMITH SERVICES, INC.
City: FORT PIERCE State:FL Address: 1306 29TH STREET
Zip Code: 34949 r Fax: City: VERO BEACH State:FL
Phone No. � g�1 `'IQ!�:tf Zip Code: 32960 Fax: 772-299-4994
E-Mail: Phone No. 866-592-8268
Fill in fee simple Title Holder on next page(if different . E-Mail: FRANCES—BROWN@SMITHSERVICES.ORG
from the Owner listed above) State or County License: CAC1816178
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
07/29/2015 WED 15: 43 FAX 2002/004
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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 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- t inspection. If you intend to obtain financing, consu with lender or an attorney before
comm cin work or recoy0ing your Notice of Commencemen .
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me Thefor oIng instrum nt was acknowledged before me
this day of �1� 1 20 lS by this f day of IL,\, 20\�__by
(Name of person acknowledging) (Name of person acknowledging)
7SIO'kirk of Notary Pu lic-State of Florida) (Sign t
r of Notary P blic-State of Florida)
Personally Known_,AOR Produced Identification Personally Known L----6R Produced Identification
Type of Identification Produced lrJentificaticn Produced
O ti JOYCE MIC UD I'
Commission No.� (��3C_l0(„ } MYCOMMISSION F�C(igpi lion No. r�b�3�L� yo
EW EXPIRES:Aptll 2018 IOYCE MiCHAUD
' Bonded Thm Notary PO4 undeiwrrte;: �:: MY COMMISSION I!FF C83
EXPIRES: riI 25,2018
Bonded ThmNotary u enn
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS