HomeMy WebLinkAboutQuackenbush, Allan permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7128120 Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FORWR CONDITION
PROPOSED IMPROVEMENT LOCATION:
Address: 9328 SCARBOROUGH COURT
Property Tax ID #: 3322-507-0014-000-5
Site Plan Name: QUACKENBUSH
Project Name: QUACKENBUSH
Residential X
Lot No. 9
Block No.
DETAILED DESCRIPTION OF WORK:
INSTALL NEW 2.5 TON, 16 SEER MITSUBISHI MINI SPLIT MUY-D30NA, MSY-D30NA WITH NEW ELECTRICAL RAN
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION'.
Additional work to be performed under this permit –check all that apply:
Mechanical _ Gas Tank —Gas Piping _ Shutters
Windows/Doors Pond
i� Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 6300.00 Utilities: —Sewer —Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name ALLAN QUACKENBUSH
Name: JOHN PANKRAZ
Address: 9328 SCARBOROUGH CT
Company: ELITE ELECTRIC AND AIR
City: PORT ST LUCIE State: _
Zip Code: 34986 Fax:
Phone No. 724-747-2561
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 & EC13006036
- – I—. a..a a u.. . v U1 a nr%.%j uru rvouce oT Commencement Is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: x Not Applicable
Name:
Address:
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before rmmnnPnring Wnrl[ nr rarnrrlincr „nrrr ni„+,moo .,f r,,. , .+
Signature of ner/ Lessee/Contractor as Agent for Owner
Signature of Co actor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST LUCIE
COUNTY OF ST LUCIE
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
x Physical Presence or Online Notarization
this 28 day of JULY 2020 by
this 28 day of JULY 2020 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 Identificatio
Type of Identification
Produced i KONNI VENAE DEWITT
Pr
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Notary P'ibljC — State of Florid8
GG 166915
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. Ex ices Dec 10, 2021
;= `` Notary Public — State of Florida
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{Signature of Notary PhNat1oria1LlohryAssn.
(Sign atur of Nota PtiF
Commission No. GG166915 (Seal)
Commission NO. GG166915 (Seal)
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