HomeMy WebLinkAboutBuilding Permit Application 10/23/2017 12:17 1 ELITE ELECTRIC INC PAGE 02
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10125/2017 Permit Number:
a J�Iit•�l! !� "'al �;i�yl�
Building Petmit Application RE' CE, VED
Planning and Development Services
Building and Code Regulation Division OCT 2 2017
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462'-1578 Commercial R ffl al-tmen
FIL
PERMIT APPLICATION FOR: Electrical
Address: 12903 NW HARBOUR RIDGE BOULEVARD PALM CITY,FL.34990
Legal Description: HARBOUR RIDGE-PLAT 13-BUTTONBUSH VILLAGE UNIT 1 (OR 2322-1570)
Property Tax ID#: 4426-815-0008-000-8 Lot
Site Plan Name: STAFFORD Bloc Na.
Project Name:
Setbacks Front Back: Right Side: Left Side:
4
extend 15/20 a 125v to 25 ft. from existing power source for rolling shutter system.
t,
Add
itiona wor to e e orme un er t is permit M c ec a appy:
HVAC Cas Tank Gas Piping _Shutters F. Windows/Do rs
ZElectric Plumbing E]SprinklersGenerator Roof Roof pitch
Total Sq.Ft of Construction: Sq. of First Floor:
Cost of Construction:$ 830.00 Utilities:E]Sewer OSeptic Building Heigh
Y.
.Name Erroll Stafford Name: John A Pankraz
Address:12903 Harbour Ridge Blvd. Company: Elite Electric&Air,Inc.
City: Palm City State:Fl Address: 1691 SW S Macedo Blvd.
Zip Code: 34990 Fax: City: Port St.Lucie ate:FI
Phone No. Zip Code. 34984 Fax: 772-34 -3702
E-Mail: Phone No. 772-340-3797
Fill in fee simple Title Holder on next page(if different E-Mail: Permit@eliteelectricandair.com
from the Owner listed above) State or County License: EC13006036
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
10/23/2017 12:17 1 ELITE ELECTRIC INC PAGE 03
DESIGN ER/ENGINEER: Not Applicable MORTGAGE.COMPANY: Not A pliable
Name:..
Address Addrwssc::
City:. State: City: - ate:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not A licable
Name:_ Name:
Address:_ Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFiDVIT:Application is hereby made to obtain a permit to do the work and installati in as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit,
St.Lucie Counr makes no representation that is granting a permit will authorize the permit holder to build the subje t structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or irohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may a ply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the w k
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-resideh al use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying Ice for
improvements to your property.A Notice of Commencement must be recorded and posted on t jobsite
before the first inspection. if you intend to obtain financing, consult with lender or an attorney b fore
commencing work or recording your Notice of Commencement.
Signature of Owner ssee/Contractor as Agent for Owner Signatur arLOR
actor/License Holder
STATE OF FLORIDA STATE OIDA
COUNTY OF Saint!_ude COUNTY OF saint Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged be a nie
this 25th day of October ,204 by this 25th day of October 20 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 Identifi ation
Type of Identification Type of Identification
Produced Produced
(Signature of 6(otary Public-State df Florida) (Signature of Not ry Public-State of F arida)
Commission No. GG20372 'NUMYLEELANGFORD ommission No. Gc2037z
CYLEELANGFRI
fw" MY COMMISSION#GG20372 � COMMISSION#GG2 7
1; HIES:October 12.2420 IBES:October 12,2 0
OFFV
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW . REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8 1