HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/28/20
Planning and Development services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: ELECTRICAL
PROPOSED IMPROVEMENT LOCATION:
Address: 9604 CROOKED STICK LANE
Permit Number.
Building Permit Application
Commercial Residential X
Property Tax ID #: 3327-711-0018-000-5
Lot No. It
Site Plan Name: CERVENY
Project Name: CERVENY Block No.
DETAILED DESCRIPTION OF WORK:
CUSTOMER IS IN PROCESS OF REMODELING KITCHEN AREA, WE ARE REROUTING WIRING, KITCHEN OUTLET
CIRCUITS FOR KITCHEN ISLAND AND ALSO REPLACING DISHWASHER AND GARBAGE DISPOSAL OUTELTS,
*** CUSTOMER WILL BE APPLYING FOR THEIR OWN PERSONAL REMODEL PERMIT AS WELL ***
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical — Gas Tank —Gas Piping _ Shutters
Electric
Total Sq. Ft of Construction:
Plumbing _Sprinklers Generator
Cost of Construction: $ 2302.59
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
OWNER/LESSEE: CON
Name ROBERT CERVENY NamE
Address: 9604 CROOKED STICK LANE Comp
City: PORT ST LUCIE State: J {r AddrE
Zip Code: 34986 Fax: City: _ 1
Phone No. 772-466-6394 Zip Cc
E-Mail: Phone
Fill in fee simple Title Holder on next page ( if different E-Mai
from the Owner listed above) State
Windows/Doors
— Roof Pitch
Building Height:
TRACTOR:
JOHNPANKRAZ
any: ELITE ELECTRIC AND AIR
ss: 1691 SW SOUTH MACEDO BLVD
SORT ST LUCIE State: FL
d e: 34984 Fax: 772-340-3797
No 772-340-3797
PERMIT@ELITEELECTRICANDAIR.COM
)r County License EC13006036
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
�>ILIVVLLMENTAL CONSTRUCTION LIEN LAW INFOR
DESIGNER/ENGINEER: Not Applicable
MC
Name:
Nar
Address:
Adc
City: State:
City
Zip: Phone
Zip:
FEE SIMPLE TITLE HOLDER: Not Applicable
BOP
Name:
Address:
Narr
City:
Add
Zip: Phone:
City:
Zip:
MATION:
IRTGAGE COMPANY: Not Applicable
ne:
Iress:
r: State:
Phone:
dDING COMPANY: Not Applicable
1e:
ress:
Phone:
OWNER/ CONTRACTOR AFFIDVITa 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. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
G -
Signature of Owner/ Le e/Contractor as Agent for Owner Signature of Contractor/Li nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF sT LuclF
The for ping instrument was acknowledged before me The for ping instrument was acknowledged before me
this 2 day of �/+ JFr� 20 ?0 by this 2- day of SF-r-J L/ /i -1 20
lo by
JOHN PANKRAZ
JOHN PANKRAZ
Name of person making statement, Name of person making statement.
Personally Known _. A OFF Produced Identification Personally Known � OR Produced Identification
Type of Identification Produced Type of Identification
Produced
ayw7,;; KONNI LENAE DEW6?T --
-_ ' a` Notary Pualic — SL rae of Florida
/"'•,,, KONN! LENAE GEWITT
Corrnss;or 4 GG 165915 — Notar
c ?C, 2021 , Y Public — S#ate of Florida
µ n; v + Commission t{ GG 166915
(Signature of NotaryFs t S,fe n ids , �f Yr �atiaaafnularyA<sn (SIgnatifre o o ary Publi St iptit^ aa ,1. 7res EC ,21
ScTt ed,hrpu96 NaNunal Nol, ryAssn
Commission No. GG166915 (Seal)
Commission No. cG166915 (Seat)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLF MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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