HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /
Date: ( '1 , b Permit Number: (97- �
RECEIVED
! I
Building Permit Application JUL 16. 2Q16
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 XXX Residential
PERMIT AIIPPLICATION FOR: To Select from dropbox, click arrow at the end of.line
PROPOSED IMPROVEMENT .00ATIQN ,
Address: 10978 S. Ocean Dr.
Legal Description: 12 3741 N 307.02 FT OF SLY 1013.02 FT,AS MEAS ALG AIA,OF GOVT LOT 2 LYG E OF A1A(2.90 AC)(OR 2856-818)
I
i
Property Tax ID#: 4512-331-0002-020-1 Lot No.
Site Plan Name: Block No.
Project Name: Marriot Courtyard Jensen Beach
Setbacks Front Back: Right Side: Left Side:
�fOETAICED DESCRIPTION QF UVORK } ,
Remove existing roof top package unit to install new roof top package unit on existing base. This is
an exact like for like change out. Connect to existing piping and duct work. e�C 1 S + j r J 'i -
K} 777777,
Y
CONSRUCTIINFORMATIONn ,
- „ ON�,s
. Additionalworkto e �.a� ,
e orme under t ispermit–check a appy:
✓❑—HVAC' —Gas Tank Gas Piping a_Shutters Windows/Doors
Electric E] PlumbingOSprinklers E Generator ❑ Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
k
Cost of Construction:$ 60,000.00 Utilities: —Sewer F]Septic Building Height: _
6VU;NER/LE55E 'gin . ._ ' CONTRACTOR.:: n
Name Oprock LLC Name. Theodore Michaelson
Address: 140 E 45th Street FI34 Company: AMI Air Condition and Mechanical, Inc.
City: New York State:NY Address: 1865 SW 4th Ave. D3
Zip Code: 10017 Fax: City: Delray Beach State: FL I�
Phone No.561-279-9900 Zip Code: 33444 Fax: 561-265-3309 I
E-Mail: Phone No. 561-243-8001 f y
Fill in fee simple Title Holder on next page (if different E-Mail: amiac@bellsouth.net
from the Owner listed above) State or County License: CAC036813
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. ,(
i�
SUPPLEII/IENTAi C�NSTRtICTtON LIEN LAIN INFRMATI�N '
q 1
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLUITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
i
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
commencin I g work or recording our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA �j STATE OF FLORIDA,"
COUNTY OF � 8"GI, COUNTY OF'
F 1�,t t `Y! eQ C�
The forgoing instrument was acknowledged before me The forgoing instr ment was acknowledged before me
this 157clay of JU I id 20/1by this S day of 20 f! by
rV 1Q
et2
(N a of per olanowledging) (N erson acknowledging)
(Si#tureoRNotary PPublic- ate of lorida) (Sign\dture of Notary Public-Slite of Florida )
Personally Known V OR Produced Identification Personally Known OR Produced e tif' a 'o
Type of Identification Type of Identification P
•`+'a'r'°�e'�''•, PATRICIA MATTEIS ,�e��vo�i�.,� PATRICIA
`` �•; �1= . Notary 1. State of
-it
Commission,No.NY 1 _ Notar �691i�-State of Florida Commission No 1� ,� My Comm.Expires Mar 16,2018
My,Coram.Expires Mar 16.2018 '.�,, P�•�
•a�,e mss; Commission#FF 102071 ;,;o",orc Commission N FF 102071
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE,
INITIALS j