HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11-24-17 Permit Number:
_ } 4 71
wa
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: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 389 SE GAS PARI LLA AVE
Legal Description: RIVER PARK - UNIT 4 BLK 37 LOT 22 (MAP 34128N) (OR 933-1497: 3480-661: 4052-1409)
Property Tax ID #: 3419-530-0150-000-9 Lot No. 22
Site Plan Name: LAWSON Block No. 37
Project Name: LAWSON
Setbacks Front Back: Right Side: Left Side:
[_DETAILED DESCRIPTION OF WORK:
REPLACE AC LIKE FOR LIKE, 3.5 TON, 17 SEER CHAMPION TC7134221, AE42CX21+TXV, 10 KW
CONSTRUCTION INFORMATION:
Additional war to ] ! Orme un er this permit— check a appy:
L"JHVAC i Gas Tank ❑Gas Piping�_ Shutters
_I Windows/Doors
Electric Plumbing Sprinklers [ Generator E]Roof Root pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 6030.00 Utilities: Sewer O Septic Building Height:
I
OWNER/LESSEE:
CONTRACTOR:
NameMARILYN LAWSON Name: JOHN PANKRAZ
Address: 389 SE GASPARILLA AVE Company: ELITE ELECTRIC AND AIR
City: PORT ST LUCIE State:FL Address: 1691 SW SOUTH MACEDO BLVD
Zip Code: 34983 Fax: City: PORT ST LUCIE State: FL
Phone No. 772-336-9931 Zip Code: 34984 Fax:
E-Mail: Phone No. 772-340-3797
Fill in fee simple Title Holder on next page ( if different E-Mail: PERMIT@7a ELITEELECTRICANDAIR.COM
from the Owner listed above) State or County License: CAC1816433
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
Na,,II me: MARILYN LAWSON
MORTGAGE COMPANY: X Not Applicable
NaJOHN PANKRAZ
Address: 389 SE GASPARILLA AVE
�,1me:
Address: 369 SE GASPARILLA AVE
City. PORT ST LUCIE State:
Zip: Phone
City: PORTSTLUCIE State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address: 1691 SW SOUTH MACEDO BLVD
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation 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 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 1 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 re r ing your Notice of Commencement. A
Signature of Owner/ Lessh9fContractor as Agent for Owner
STATE OF FLORIDA, I
COUNTY OF Ill
The forgoing instru a wa acknowledged before me
this y of 20by
I-,awj
Dame of pe o making statement
Personally Known OR Produced Identification
Type of Identification
Produced
Signature of Contrac�icense Holder
STATE OF FLORIDA' i
COUNTY OF ,L
The for of g instru en was acknowledged before me
this ay of 20 by
Name of persowmaking statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notdry Public- State of Flor a) (Signature of No ry Public- State of Florida
�Yp
_Imission N�{
CY LEE LANGF(R !ANCYLEELANGFCommission No. o.�.
My ComN[ISSION 0 GG2 "2 MY COMMISSION k GG203'
EXPIRES: Octob r 12, 20 0�E)MRES: October 12 2020 OFFIV"
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17