HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4123118
Permit Number:
Building Kermit 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: 5503 LUCILLE LN
Legal Description: LAKEWOOD PARK - UNIT 4 - BILK 27 LOT 4 (MAP 1311 1 S) (OR 3051-2625)
Property Tax ID 4: 1301-604-0034-000-8
Site Plan Name: HINRICH
Lot No.4
Project Name; HINRICH
Block No. 27
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WOR[:
REPLACE AC LIKE FOR LIKE, 3 TON, 19 SEER LENNOX XC21-036-230-10, CBX40UHV-30 ICF, 9
KW
CONSTRUCTION INFORMATION:
A—dUIteona wor to jee arme un er
®HVAC u Gas Tank
Electric Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 7450.00
Ines permit —cl
DGas Piping
OSprinklers
all app-l—y:
f� Shutters
LJ Generator
Sq. Ft. of First Floor: _
Utilities: Li Sewer ❑ Septic
OWNER/LESSEE:
Name PATRICIA HINRICH
Address: 5503 LUCILEE LN
City: FORT PIERCE
State: FL
Zip Code: 34951 Fax:
Phone No. 772-240-1232
E -Mail: PATHINRICH@ATT.NET
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
[Windows/Doors
0 Roof Roof pitch
Building Height:
Name: JOHN A. PANKRAZ
Company: ELITE ELECTRIC AND AIR
Address: 1691 SW SOUTH MACEDO BLVD
City: PORT ST LCUIE
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.
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Building Kermit 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: 5503 LUCILLE LN
Legal Description: LAKEWOOD PARK - UNIT 4 - BILK 27 LOT 4 (MAP 1311 1 S) (OR 3051-2625)
Property Tax ID 4: 1301-604-0034-000-8
Site Plan Name: HINRICH
Lot No.4
Project Name; HINRICH
Block No. 27
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WOR[:
REPLACE AC LIKE FOR LIKE, 3 TON, 19 SEER LENNOX XC21-036-230-10, CBX40UHV-30 ICF, 9
KW
CONSTRUCTION INFORMATION:
A—dUIteona wor to jee arme un er
®HVAC u Gas Tank
Electric Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 7450.00
Ines permit —cl
DGas Piping
OSprinklers
all app-l—y:
f� Shutters
LJ Generator
Sq. Ft. of First Floor: _
Utilities: Li Sewer ❑ Septic
OWNER/LESSEE:
Name PATRICIA HINRICH
Address: 5503 LUCILEE LN
City: FORT PIERCE
State: FL
Zip Code: 34951 Fax:
Phone No. 772-240-1232
E -Mail: PATHINRICH@ATT.NET
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
[Windows/Doors
0 Roof Roof pitch
Building Height:
Name: JOHN A. PANKRAZ
Company: ELITE ELECTRIC AND AIR
Address: 1691 SW SOUTH MACEDO BLVD
City: PORT ST LCUIE
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/ENGINE1R:
Name: PATRICIA HINRICH
�1
Address: 5503 LUCILLE LN
city: FORT PIERCE
Not Applicable
State:
MORTGAGE COMPANY;
Name; JOHN A. PANKRAZ
Not Applicable
Address: 5503 LUCILEE LN
City: PORT STLCUIE
Zip: Phone
Zip: Phone:State:
FEE SIMPLE TITLE HOLDER:
Name;
Not Applicable
BONDING COMPANY:
X Not Applicable
Address: 1691 sw so1TH MACEUO BLVD
Name:
Address:
city:
Zip: Phone:
City:
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 y work or installation has commenced prior to the issuance of a permit.
wh ch is noconflicmt with any applicableiHo that
Owners Assoc at, nl ru es authorize
or and covenants that may restrict or prop bit 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 you intend to obtain financing, consult with lender or an attorney before
Commencing work or recordin o'ur Notice of Commencement. /
Signature of Owner/
STATE OF FLORI
COUNTY OFS'LU E
as Agent for Owner
The forsoing instrument was acknowledged before me
this 2 day of 20_1by
JOHN A. PANKRAZ
Name of perso making statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of
•.........tr' - KONNI LENAE D
Notary Public—State
+ f? v Commission # GG
mm. Ex ires D
(Aa 2. ' Bonded through National
Commission No. C61(*(0 ; (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
BATE
COMPLETED
Rev. 8/2/17
SUPERVISOR
REVIEW
Signature of Contrac or/ icense Halder
STATE OF FLORIDA
COUNTY OFs,LUC,E
The forgoing instrument was acknowledged before me
this ---L)day of A -,o 0lL 2Q_ by
JOHN A. PANKRAZ
Name of person making statement
Personally Known _' OR Produced Identification
Type of Identification
d
MITT
of Florida; .•tip Y';; KONNI LENAE DEWITT
16691- --- -- ", *`t, _ Notary Public— State of Florida
c 10, 20 ; » • _ Commission # GG 166915
J0 re of Notary Public -S t''d�al�di
t }
..,.,, ed llrroayh Naldanal NotaryAssn.
Commission No. CSG ic_L- `Ig (Seal)
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW