HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/9/2020 Permit Number:
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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: MECHANICAL - AC CHANGE OUT
Address: 10305 S INDIAN RIVER DR. FORT PIERCE, FL 34982
Property Tax ID #. 3529-701-0003-000-6
Site Plan Name: RICH, KARINE
Project Name: RICH, KARINE
. l& I Y ty ,9
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit- check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric —Plumbing _Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 4780.00
Lot No.
Block No.
— Windows/Doors Pond
— Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
Name KARINE RICH
Address: 10305 S INDIAN RIVER DR
City: FORT PIERCE State: _
Zip Code: 34982 Fax:
Phone No. 607-435-9239
E-Mail: KARINE2X21@GMAIL.COM
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
F .... 1.._ _2 :--- `- .,.
Name: JOHN PANKRAZ
Company: ELITE ELECTRIC AND AIR
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 PERMIT@ELITEELECTRICANDAIR.COM
State or County License CAC1816433
-- - - - ��• •��• � •�•• •� «vimwi mui t:, a nr%.vrtUcLj ivozice or commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
'SUPPLEMENT, CONSTRUCTION LIEN' LAW �IN°FORMATION:
DESIGNER/ENGINEER: x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
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:
OWNER/ rnNTRAfTnR ACCmvir.
-- — —•- • •• - • MPHIB-aLIU11 Q mirauy made m ootain 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 commencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTYOF
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this 12.- day of 0 2020 by
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State
Florida )
Commission No. 66 ii c 4i,§ (Seal)
Signature of Contra,WLicense Holder
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
A Physical Presence or Online Notarization
this 9 day of 0C roe.° 2020 by
Name of person making statement.
Personally Known % OR Produced Identification
Type of Identification
Produced -,-
(Signature of Notary Public- State of Florida )
Commission No. Gsfpep $e (Seal)
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DATE
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COMPLETED
Rev. 5/6/20