HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/2/20 Permit Number:
�Ir
Building Permit 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: ELECTRIC
PROPOSED IMPROVEMENT LOCATION:
Address: VbU4 UHUUKED STICK LANE
Property Tax ID #: 3327-711-0018-000-5
Site Plan Name: CERVENY
Project Name: CERVENY
Lot No. 11
Block No.
DETAILED DESCRIPTION OF WORK: -
SUPPLY, WIRE AND INSTALL A DEDICATED 40 AMP CIRCUIT FOR A 38 AMP INSTA-HOT FOR THE MASTER BATHROOM,
SUPPLY AND INSTALL A DISCONNECT, BATH FAN
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
x Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 2002.71
_ Generator
Sq. Ft. of First Floor:
Windows/Doors Pond
_ Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ROBERT CERVENY
Name: JOHN PANKRAZ
Address: 9604 CROOKED STICK LANE
Company: ELITE ELECTRIC AND AIR
City: PORT ST LUCIE State: L
Zip Code: 34986 Fax:
Phone No. 772-466-6394
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 EC13006036
IMULMU U1 A-ommencement 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 I RACTOR 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 attornev before com encing work or recordino vour Notice of Commencement
C�
Signature of 0 ner/ Lessee/Contractor as Agent for Owner
Signature of Contr for/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 day of 2020 by
this day of
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 Identification
Type of Identification
Produc
(6hr4 LENAE uEVVI
"Y'
Produced
KO11N1 E JAE DENii?T
o Public State
I e ary Public— State of rloritla
15 315
ary of Florida
„ Commission i GG 15oQ15
" ) ; GG
c ommi ;slol
T
9R ri ti o My Comm. Expires Doc 10 2021
(Signature of Notaryn
u bondedt(0 ' Ronal Nola Assn.
(Signature o Notary Pub
r igh NaJonal Io4�r A sn.
Commission NO. GG1 9 (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
P V ri