HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/20/20107
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: Electrical
Address: 389 SE Gasparilla Avenue
Legal Description: RIVER PARK -UNIT 4 BLK 37 LOT 22 (MAP 34/28N) (OR 933-1497: 3480-661: 4052-1409)
Property Tax ID #: 3419-530-0150-000-9
Site Plan Name: Lawson
Project Name:
Setbacks Front Back:
Lot No. 22
Block No. 37
Right Side: Left Side:
run dedicated circuit from panel to AH for ac install
❑ HVAC
❑✓— Electric
"Shutters
❑ Plumbing Sprinklers ❑ GeneratorRoof pitch
❑ Windows/Doors
Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 0- inc. with ac install
S Ft. of First Floor: _
Utilities. — Sewer F—] Septic
Name Marilyn Lawson
Address: 389 SE Gasparilla Avenue _
City: Port St. Lucie State: FL
Zip Code: 34983 Fax: _
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: John A Pankraz
Building Height:
Company: Elite Electric & Air, Inc.
Address: 1691 SW S Macedo Boulevard
City: Port St Lucie State: FI
Zip Code: 34984 Fax: 772-340-3702
Phone No. 772-340-3797
E -Mail: Permit@eliteelectricandair.com
State or County License: EC 13006036
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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4
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: _ Name:
Address: Address:
City:_ State: City: - State:
Zip: Phone _ Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: ANot Applicable
Name:_
Name:
_
Address:_
Address:
City:
City:
s
Zip: Phone: _
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 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 ins tion. If yo nci to obtain financing, consult with lender or an attorney before
commencing r oVrecor-dKg vour Notice of Commencement.
C _
Signature of Owner/a194/Contractor as Agent for Owner
Signatu Contr ctor icense Holder
STATE OF FLORIDA
STATE OF FLO IDA
COUNTY OF SL Lucie
COUNTY OF St. Lucie
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged efore me
this 20th day of November . 20by
this 20th day of November 20_L/ 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 Identification
_
Type of Identification
Type of Identification
Produced
(Signature of Not Public- State of Flo4a a)
Produced
(Signature of Notary P blic- State of Florida )
Commission No. oc2os�2 )NANCY LEE
mission No. cc20372 ea
MY cohaffssioN # GG
3,ELANGFORDRXPIRFS:
Octobr 12,
1 SSION # GG20372
0ctoba
OF 12 20
'.
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17