HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; 12/11/17 Permit Number:
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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
PROPOSED IMPROVEMENT LOCATION:
Address: 210 NE JARDAIN RD
Legal Description: RIVER PARK - UNIT 9 - PART B BLK 73 LOT 19 (MAP 34/28) (OR 1121-2341: 2336-2764)
Property Tax ID #: 3419-565-0025-000-2 Lot No. 19
Site Plan Name: SMITH Block No.
3
Project Name: SMITH
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REPAIR EXISTING OUTLET FOR GARAGE DOOR OPENER TO BRING IT UP TO CODE
CONSTRUCTION INFORMATION:
Additional work to be e Orme un er t is permit — check a appy:
HVAC Gas Tank Gas Piping Shutters nWindows/Doors
_Generator
E Electric Plumbing Sprinklers 0
Roof
Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 529.02 Utilities: Sewer []Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
NameJEFFREY SMITH Name: JOHN PANKRAZ
Address:210 NE JARDAIN ROAD 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: F
Phone No. 772-249-6266 Zip Code: 34984 Fax: 772-340-3702
E -Mail: Phone No. 772-340-3797
Fill in fee simple Title Molder on next page ( if different E -Mail: PERMIT@a 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name: JEFFREY SMITH
MORTGAGE COMPANY: Not Applic
Name: JOHN PAiJKRAZ
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Add ress: 210 NE JARDAIN RD
Add ress: 210 NE JARDAIN ROAD
City: PORTSTLUC#E State
COUNTY OF
City: PORTSTLUCIE State:
Zip: Phone
FEE SIMPLE TITLEHOLDER: Nat Applicable
Name:
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Zip: Phone:
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BONDING COMPANY: Not Applicz
Name:
Address: 1691 sw souTH MACEDO BLVD
Address:
City:
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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 prohi it 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 lor
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you !pt -end to obtain financing, consult with lender or an attorney before
commencing work or r dinj gbur Notice of Commencement.
Signature of Own/Contractor as Agent for Owner
Signature of Cc
STATE OF FLORIDA � �
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REVIEWS FRONT ZONING
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Rev. 8/2/17
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