HomeMy WebLinkAboutBlack and White0424All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/5/20
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Planning and Development services
Permit Number:
Building Permit Application
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: MECHANICAL - AC CHANGE -OUT
Address: 180 CAM DEL RIO, PORT SAINT LUCIE, FL 34952 (MOBILE HOME)
Property Tax ID #: 1009835
Site Plan Name:
Project Name:-MALLWITZ, MARK
Lot Na.
Block No.
REPLACE AC, LIKE FOR LIKE, OF A 3.5 TON, 14 SEER RUUD, RSPMA043JK, PAKAGE UNIT, 10 KW
New Electrical Meter Second Electrical Meter
Additioonnayworkto be performed under this permit—check all that apply:
Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors _Pond
_Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of construction: $ 5834.00
_Generator _Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
• �..••�.• �...��•• o cziuu or more, a newnueu Notice of commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
ONTRr v(F a4X3, " s
Name MARK MALLWITZ
Name: JOHN PANKRAZ
Address: 180 CAM DEL RIO
Company: ELITE ELECTRIC AND AIR
City: PORT SAINT LUCIE State: FL
Zip Code: 34952 Fax:
Phone No. 772-828-8945
Address: 1691 SW SOUTH MACEDO BLVD
City: PORT SAINT LUCIE State: FL
Zip Code: 34984 Fax: 772-340-3702
Phone No 772-340-3797
E -Mail: -NO EMAIL
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
• �..••�.• �...��•• o cziuu or more, a newnueu Notice of commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: x Not Applicable
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Name:
MORTGAGE COMPANY: x Not Applicable°Pu_
COUNTYOF 1 k1 (t C
Name:
Address:
Address:
City: State: _
Zip: Phone
City: State: _
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City:
City:
ZIP: Phone:
Zip: Phone:
Produced - ,.•••^•p••• KONNI LENAE ftpouceKONNI LENAE DEN
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Notary Public -SI
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 Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in co 17ict 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 attorne before commencin work or recordin o r N t' f C
u o Ice o ommencement.
Signature of Owner/L ee/ContractTr as Agent for Owner
Signature of Contractor/cee se =Holder
STATE OF FLORIDA
STATE OF FLORIDA V
COUNTYOF 1 k1 (t C
COUNTY OF SAINTLUCIE
Sworn to (or affirmed) and subscribed before me of
Jl�Physical Presence.or
Sworn to (or affirmed) and subscribed before me of
Online Notarization
x Physical Presence or Online Notarization
this 6 day of OG{-rxr_v� .2020 by _
this 5T day of OCTOBER — 2020 by
Mol
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Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification-
Personally Known x OR Produced Identification
Type of Identification
entificatian
Produced - ,.•••^•p••• KONNI LENAE ftpouceKONNI LENAE DEN
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Notary Public -SI
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