HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 415/18
Ct3UNTY
F L O R I D R
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
PROPOSED IMPROVEMENT LOCATION:
Address: 3729 SAINT MARKS DR
Legal Description: ST JAMES PARK BLK 4 ALL LOTS 10 AND 11 AND N 35 FT OF LOT 12 (OR 3413-214)
Property Tax ID #: 2434-501-0057-000-1
Site Plan Name: SHAW
Project Name: SHAW
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Lot No. 10&11
Block No. 4
INSTALL A NEW 150 AMP METER MAIN COMBO, UPGRADE THE GROUND SYSTEM, INSTALL A
PORTABLE GENERATOR HOOK UP, INSTALL A 50AMP PLUG FOR RV, INSTALL A WHOLE
HOME SURGE PROTECTOR
CONSTRUCTION INFORMATION:
AdditionalAddificinal work to be e Orme un er t is permit - c ec a app y:
t
HVAC Gas Tank Gas Piping OGenerator ShuttersElectric Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 2467.38
OWNER/LESSEE:
NameANN SHAW
SFt, of First Floor: _
Lltilities:]Sewer ❑Septic
Address:3729 SAINT MARKS DRIVE
City: FORT PIERCE State:FL
Zip Code: 34982 Fax:
Phone No, 802-282-9404
E -Mail: annkransshaw@yahoo.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: JOHN A PANKRAZ
QWindows/Doors
0 Roof Roof pitch
Building Height:
Company: ELITE ELECTRIC AND AIR
Address: 1691 SW SOUTH MACEDO BLVD
City: PORT ST LUCIE State: FL
Zip Cade: 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: ANN SHAW Name: JOHN A PANKRAZ i`
Address: 3729 SAINT MARKS DR Address: 3729 SAINT MARKS DRNE
City: FORTPIERCE City: y: PORT STLUCtE State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: 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 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.otice of Commencement must be recorded and posted on the jobsite
before the first inspection. If y intend to obtain financing, consult with lender or an a ney before
commencing work or recor our Notice of Commencement.
Signature of Owner/ a/Contractor as Agent for Owner Signature of Contract License Holder
STATE OF FLORIDA STATE OF (LORI A
COUNTY OF ST_ LUCCOUNTY OF__ C � F
The forgoing instrument was acknowledged before me
this day of For2 i L 20 R by
RHtJ r0 ,cFt jL
Name of personmaking statement
Personally Known ie OR Produced Identification
Type of Identification
- WNNI LENAE DEWITT
Notary Public - Slate of Florida
Commission # GG 166915
My Comm. Expires Dec 10, 2021
(Signature of Notary
Commission No.
Ce f we qf, (Seal)
REVIEWS
FRONT ZONING
COUNTER
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
The for oing instrument was acknowledged before me
this day of AP2fc-1 20A by
G t4 !J P'4N eC &/f- L
Name of person making statement
Personally Known _ ) _ OR Produced Identification
Type of Identification
Produced
KONNI LENAE DEWITT
Notary Public — Slate of Florida
Commission # GG 166915
(Signature of Notary Public- ate"A'$� 6rid1onyed nfough NationalNotary Assn.
Commission No. 661(4w"tf (Seal)
SUPERVISOR} PLANS �VEGE
REVIEW I REVIEW RE\
TATION
(I EW
SEA TURTLE
REVIEW
MANGROVE
REVIEW