HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/22/2016 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: To Select from dropbox, click arrow at the end of line I
Address: 10600 S. Ocean Dr # 806 Jensen Beach 34957
Legal Description: Oceana South condominium II unit 806 and undiv share in common elements (or 1040-2461: 1042-1555; 3859-2727)
Property Tax ID #: 4511-517-0083-000-3
Site Plan Name: Kupiec
Project Name: Flynn's AC
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
Replace a 2Ton AC unit with a 5KW htr, without duct replacement in a residential building
❑✓ HVAC U Gas Tank
11 Electric U Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 4720
Name Beatrice Kupiec
Address: 10600 S Ocean Dr # 806
Citv: Jensen Beach
Zip Code: 34957 Fax:_
Phone No. 772-229-8343
JC[Inu—Id ICLN au
apply.
❑
Sas Piping
Shutters
Windows/Doors
Sprinklers
Generator
Roof
SFt. of First Floor: _
Utilities: Sewer U Septic
State: FL
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Joseph Flynn
Building Height:
Company: Flynn's AC Services
Address: 1323 SW Thelma ST
City: Palm City State: FL
Zip Code: 34990 Fax: 772-781-1307
Phone No. 772-283-4114
E -Mail: mjb@flynnac.comcastbiz.net
State or County License: CAC055482
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
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 your Notice of Commencement.
11
_ Sif,/pature ofAner/ Lessee/Agent
STATE OF FLORIrJ�, STATE OF FLORID/
COUNTY OF P4� CUL I'll COUNTY OF_DV V( , 01)
The forgoing instrumen was acknowledged before me
this�.dayof� , 20 _
Tby
Personally Known 4__ OR Produced Identification
Type of Identification Produced �E3
Commission No. I1.kcOFFLO
RtQA
Revised 07115/2014
The forgoing instrument was acknowledged before me
this �`7—day of 20 &by
(Name of person acknowledgin )
(Signature of Notary Public - St 't of Florida )
Personally Known OR Produced Identification
Type of Identificatio Produced
Commission No.al���LZ'.° '
NOTARY PUBUC
STATE OF FLORI
E)Ores 101112016
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