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Date: 5129120 Permit Number:
COUP4TY
F L 0 It t r
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
PERMITTYPE:AC - NEW INSTALL
PROPOSED IMPROVEMENT LOCATION:
Address: 2880 EAGLE'S NEST WAY
Property Tax ID #: 3424-702-0141-000-6
Site Plan Name: SIMMS
Project Name: SIMMS
DETAILED DESCRIPTION OF WORK:
Commercial Residential X
Lot No. 22
Block No. 62
INSTALL NEW 2 TON, 18 SEER MITSUBISHI MINI SPLIT MUZ-HM24NA2-U1, MSZ-HM24NA-U1 PLUS NEW ELECTRICAL
CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit —check all that apply:
Mechanical _ Gas Tank —Gas Piping — Shutters
Electric Plumbing
Total Sq. Ft of Construction: _
Cost of Construction: $ 5800.00
Sprinklers _ Generator
Sq. Ft. of First Floor: _
Windows/Doors
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name ELAINE SIMMS
Name: JOHN PANKRAZ
Address: 2880 EAGLES NEST WAY
Company: ELITE ELECTRIC AND AIR
City: PORT ST LUCIE State: NL
Zip Code: 34952 Fax:
Phone No. 772-879-7918
Address: 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:
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
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.
NER/ENGINEER: X Not App
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE FOLDER: Not Applicable
Name:
Address:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City: City:
Zip: Phone: Zip:
Phone:
Not Applicable
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 ruies, 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."
i Signature of Contract /License Bolder
Signature of OwneLessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 8T wciE
COUNTY OF STLUCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 29 day of MAY '20 by
this 29 day of MAY 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
j Produced
I<o!vN! crNAr DEWi?
Notary Pub ic— �t [e cr F!oritla
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'(Signature
of Notary Pub[ FI!dt � �.xplr s ec
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(Signature of Notary P fac ts Dec ia, 2621
onalNOEaryAssn-
Commisslon No. GG166915 Seal
Commission No. GG1669.
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