HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 3000 NORTH HIGHWAY A1A, UNIT 2C
Legal Description: THE ATRIUM ON THE OCEAN II (OR 1558-594) UNIT 2-C (OR 3156-1720; 3727-1667)
Property Tax I D #: 1425-756-0003-000-1
Site Plan Name: HOUNSELL
Project Name: HOUNSELL
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Lot No.
Block No.
REPLACE AC LIKE FOR LIKE, 4 TON PACKAGE WATER SOURCE HEAT PUMP UNIT,
CFX048VLFA, 5 kw
S
CONSTRUCTION INFORMATION:
Itlona war to e ne orme un er t Is permit — c ec a app y:
HVAC Gas Tank OGas Piping OGenerator
Shutters Windows/Doors
Electric Plumbing Sprinklers Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of Firstff Floor:
Cost of Construction: $ 5426.00 Utilities: L] Sewer ElSeptic Building Height:
OWN ER/LESSEE:
Name LISE HOUNSELL
Address: 3000 N HWY A1A, UNIT 2C
City: FORT PIERCE State:FL
Zip Code: 34949 Fax:
phone No. 772-577-3026
E -Mail: LHOUNSELL@YAHOO.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: JOHN A PANKRAZ
Company: ELITE ELECTRIC AND AIR
Address: 1691 SW SOUTH MACEDO BLVD
City: PORT ST LUCIE State: FL
Zip Code: 34984 Fax:
Phone No. 772-340-3797
E -Mail: PERMIT@ELITEELECTRICANDAIR,_COM
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: Not Applicable
Name: LISE HOUNSELL
MORTGAGE COMPANY:.
Na e: JOHN A PANKRAZ
� Not Applicable
Address: 3000 NORTH HIGHWAY AIA, UNIT 2C
1m
AddresS: 3000 N HWYAIA, UNIT 2C
The forgoing instrument was acknowledged before me
City. FORT PIERCE State:
Zip: Phone
City: PORTSTLUCIE
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY:
Name:
Not Applicable
Address: 1691 SW SOUTH MACEDO BLVD
Address:
Personally Known _( OR Produced Identification
City:
City,.-
ity:Zip:
Produced
Zip:Phone:
Zip: Phone:
ignature o Notary Public- State f
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 thepermit 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 inspection. If yo intend to obtain financing, consult with lender or ap attorney before
commencing work or re-cordlil your Notice of Commenremenf /
Signature of Owne / L ee/Contractor as Agent for Owner
Signature of Con to /License Holder
STATE OF FLOR
STATE OF FLO A
COUNTY OF -u
COUNTY OF a% -Ie
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 21 day of 20I� by
this 71 day of fnA&trt . 20'l by
JOHN A PANKRAZ
JOHN A PANKRAZ
Name of person making statement
Name of person making statement
Personally Known _C,.e_ OR Produced Identification
Personally Known _( OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature o Notary Public- State of Florida
ignature o Notary Public- State f
f 0%1 LEll DEWITT
Commission No. l3t;1(451� ;',� S Public
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Commission # GG 186915
KONNI LENAE DEWI
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mmissionNo. GCil�t� s�"� allolaryPublic—State of
; Commission # GG 166
My Comm. Expires Dec 16, 2021
=,1" al' _. My Comm. Expires Dec 1
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REVIEWS
FRONT
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SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
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REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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