HomeMy WebLinkAboutBuilding Permit Application ALL • • • TO te
•• •� Number. �.
Building Permit
Application
Planning • •Development
Building and Code Regulation Division
ii Virginia Avenue,Fort Pierce FL 34982
Phone: • Commercial , Residential
PERMIT APPLICATION,
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Address.
} FORT PIERCE
PropertyLegal Description: "LmAREO SID BLKS LOTS 1,Z3,4,5.6A8 AND W112 OF LOT 16 AND ALL LOTS 16 17 18,19,20,21,2� 44(2,81 AC)(OR 614
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�-ddifiotitl-worktob-ee—rtor--m-e-d under this permit—check all ttLat
11
1]HVAC Gas Tank Das Piping Shutters
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Electric Plumbing FISprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction: Sa. Ft.of First Floor:
Cost of t } 11 01Utilities: N i
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Thomasame !
Address:Zip Code: • i
Ci V: Fort Pierce FI 1691 SW S Wcedo Blvd..
it. State: Address:
34947 Fax:
Port St.Lucia F1
•;, r i'
" • • iCode:
Fill in fee simple TitleHolder on page different • • !.• •
09/20/2017 14:25 1 ELITE ELECTRIC INC PAGE 03
I
C
DESIGNER/ENGINEER: x Not Applicable pp MORTGAGE COMPANY: Not Ap licable
N a me:Thomas Vaughn
Name:Jahn A Pankraz
Address:4311 AVENUE J FORT PIERCE Address: 4318 Avenue J
City: FortPieme State: City: Port St.Lucie I S te:
Zip: Phone Zip; Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: Not Ap licable
Name: Name:
Address:1891 sw s Macedo Blvd, Address:
City: City;
Zip: Phone: Zip: Phone: i
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and instal lati as indicated.
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 subje structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or rohlbit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may a ly.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the wo
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-residenti .I use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying t ice for
improvements to your property.A Notice of Commencement must be recor d andposted on th jobsite
before the first inspection. If you intend to obtain financing,consult ende,nor an attorney b ore
commencin work or r ouf Notice of Commencement.
Y/
i
Signature of t�wn�r./-L ss /C tractor as Agent for Owner Signatu ct License Holder
STATE OF FLORID STATE OF DA
COUNTY OFSAINT L CIE COUNTY OFSAINTLUCIE
The forgoing instrument was acknowledged efore me The forgoing instrument was acknowledged befo a me
this 21sT day Of SEPTEMBER 20 by this 21sT day of SEPTEMBER 2017 by
JOHN A PANKRAZ JOHN A PANKRAZ
Name of person making statement Name of person making statement
Personally Known x OR Produced Identification Personally Known x OR Produced Identifition
Type of Identification Type of Identification
Produced Produced
l� u_��44
� .
(Signature of No ary Public-State f FI rids} (Signature of Notary Public-State of FloridcA
GG20372 WigxN�y
mmission No. GG20372 ' d
Commission Na. LBELANGFt3 YI,SSION# FOMX COMMISSION#{1{}2 :MY C tSStON#GG2037
a�Fw 'IR88:OMobcr
2.202
FOFF d°r9 E S:0a0ber 12,2020
REVIEWS FRONT ZONING SUPERVISOR. PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/27