HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1015/20 Permit Number:
L 0
U
IL10
b�
-low
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue,Fort Pierce FL 34982
Phone.(772)462-1553 Fax:(772)462-1578
PERMIT APPLItATION'FOR:MECHAN I-CAL - AC CHANGE-OUT
FIN M-L
N®R,NOT 0111112 91"K7111 I M-IMNZ
Address: 180 CAM DEL RIO, PORT SAINT LUCIE, FL 34952(MOBILE HOME)
-Property Tax ID#: 1009835 Lot No.
Site Plan Name: Block No.
Projbct Name: MALLWITZ,MARK
REPLACE AC, LIKE FOR LIKE,OF A 15 TON, 14 SEER RUUD, RSPMA043JK,PAKAGE UNIT, 10 KVJ
New Electrical Meter Second Electrical Meter
Additiona- orktobe performed under this permit-check all that apply:
=echanic'a-I —Gas Tank Gas Piping Shutters Windows/boors Pond
Electric Plumbing Sprinklers Generator Roof Pitch
Total Sq-. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 5834.00 Utilities: —Sewer _Septic Building Height:
Name MARK MALLWITZ Name:JOHN PANKRAZ
Address:180 CAM DEL RIO Company:ELITE ELECTRIC AND AIR
City: PORT SAINT LUCIE State:FL Address:1691 SW SOUTHMAGEDO BLVD
Zip Code: 34952 Fax: City: PORT SAINT LUCIE. State:FL
Phone No.772-828-8945 Zip Code: 34984 Fax: 772-340-3702
E-Mail:NO EMAIL Phone No 772-340-3797
Fill in fee simple Title Holder on next page(if different E-Mail PERMIT@ELITEELECTRICANDAIR.COM
from the Owner listed above) State or County License CAC1 816433
If value of construction is 2500 or more,a-RECORDED Notice of Commencement is required.
LIf value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
fGas -',eY. p�.:=w.?- ,,,, .C$.. `ty'n?' r� xr �:�,ci:�, 'FSS' !;T..' 'F +,}� -. 't''o,-.,�. 'q , ,' fF .. �.r R,r.•.�.a ;�5W y"...
SU'F'PLEME�NTAL C® R11C�1"I®a L1 " :a:l1,FC1,( , `fI01 Awa% e <e � � h . *u � X>
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone, zip; Phone:
FEE SiMPLE TITLE HOLDER: x Nat Applicable BONDING COMPANY: x Not Applicable
Name: 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,l 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 commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/L ce se Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY r OF SAtNTLUGIE
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization x Physical Presence or Online Notarization
this day of 2020 by this 5TH day of ocroaea ,202G by
deo,A 1,r 1 p k)l C 325
Name of person making statement. Name of person making statement.
Personally Known OR Produced identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
rl
Produced Produced ^' K(Notary
Notary Public-Stale of a
« • .= Commission#GG 16 9
-:r• ,«=s M Comm_Expires Dec Q, 21
(Signature of Notary Public-State of Florida} (Signature of Notary Public-State i i'or9ffa°)' a°lWedh°ug"so
Commission No. (Seal) Commission No,C`?GT I(ntwgJ11 (Seal)
REVIEWS FRONT ZONING SUPERVISOR 'PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.