HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5122120 Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (77.2) 462-1578
PERMIT TYPE: MECHANICAL
PROPOSED IMPROVEMENT LOCATION:
Address: 8033 LONG DRIVE
Property Tax ID ##: 3425-707-0141-000-4
Site Pian Name: KLIMACEK
Project Name: KLIMACEK
Building Permit Application
Commercial Residential X
Lot No, 41
Block No. 37
DETAILED DESCRIPTION OF WORK:
INSTALLING NEW 1 TON, 18 SEER MITSUBISHI MINI SPLIT MUZ-HM12NA2, MSZ-HM12NA, INSTALLING IN
FLORIDA ROOM, ELECTRICAL INCLUDED
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit –check all that apply:
X Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing —Sprinklers Generator i Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction., 5200.Oq Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name PATRICIA KLIMACEK
Name: JOHN PANKRAZ
Address: 8033 LONG DRIVE
Company: ELITE ELECTRIC AND AIR
City: PORT ST LUCIE State: 1=L -Address.
Zip Code.. 34952 Fax: s
Phone No. 315-982-1778
1691 SW SOUTH MACEDO BLVD
City: PORT ST LUCIE State: FL
Zip Code: 34984 Fax: 772-340-3702
Phone No 772-340-3797
E -Mail: PARK620@GMAIL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail PERMIT@ELITEELECTRICANDAIR.COM
State or County License CAC1816433
I uaiur u, iunstruction is ,)c-nuu or more, a K1:LUK1AAJ Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNER/ENGINEER:
Name:
XX Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone
State:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
C Not Applicable
BONDING COMPANY: Not Applicable
Name:
Address:
this zz day of MAY 20_ by
Address:
City:
JOHN PANKRAZ
City:
Zip: Phone:
Name of person making statement.
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 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 ali 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."
Signature of own / Lessee/Contractor as Agent for owner
Signature of Contra _'r/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF srcuaE
COUNTY OF sr LUCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was
acknowledged before me
this zz day of MAY 20_ by
this 22 day of �nAv
20_ by
JOHN PANKRAZ
JOHN PANKRAZ
Name of person making statement.
Name of person making statement.
Personally Known X OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
`�
— KOI NII i_ENAE DEU rT
Not i y PUNIC Sinie Of Floods
.� _F
KCJI:E I �fv.Ar DER -F1'
r ;` Mn:-sion # GG 1669,15
II>': i 2021
., Notary Pubs+c - 5121e �f Florida
�i, Commission # GC 166915
'
t " r i` y Gon ri. Exp res er,1 ,
. .
° �� '�
(Signature y ��
of Notar Public ta'te�of�l '1f9`''' "
{Signature of Notary Public
,<•' , w,kre.soec 1u 2021
ta't�;!�•fiF1'or�el��°)����,y3,r�.�re���iN��r,3ryrs5,.
Commission No. GG166915 (Seal)
Commission No. GG166915
(Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED