HomeMy WebLinkAboutBuilding permit application —r
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED sv
10/15/2020 Permit Number:
Date:
1
° ' 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 APPLICATION FOR:MECHANICAL / AC CHANGE-OUT
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Address: 18 MEDITERRANEAN BLVD SOUTH, PORT SAINT LUCIE, FL 34952
Property Tax ID#: 3426-500-1090-000-6 Lot No.
Site Plan Name: REILLY, HELEN Block No.
Project Name: REILLY, HELEN
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New Electrical Meter Second Electrical Meter
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Additio AI work to be performed under this permit—check'all that apply:
_Mec anical _Gas Tank —Gas Piping _Shutters -Windows/Doors _Pond
_ Electric Plumbing Sprinklers Generator _Roof Pitch
Total Sq. Ft of Construction: Sq.Ft. of First Floor:
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Cost of Construction:$ d Utilities: _Sewer _Septic Building Height:
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�N�ERLESSEdE C„O�NTR�ACTOR•,� aF
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Name HELEN REILLY Name:JOHN PANKRAZ
Address:18 MEDITERRANEAN BLVD SOUTH Company:ELITE ELECTRIC AND AIR
City: PORT SAINT LUCIE Stater Address:1691 SW SOUTH MACEDO BLVD
Zip Code: 34952 Fax: City: PORT SAINT LUCIE State:FL
Phone No.310-617-2223 Zip Code: 34984 Fax: 772-340-3702
E-Mail:HELENAREILLY@MORESMARTS.COM 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 CAC1816433
If value of construction is 2500 or more,a RECORDED 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 MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone 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/CONTRACTOR.AFFIDVIT:Application is hereby made to obtain a permit to do the'work and installation as indicated.
1 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 attoroey before commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee.Co tractor as Agent for Owner Signature of Contractor/'ic nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Sl�.i n 1Q Cp,� COUNTY OF I C�c
Sworn to(or affirmed)and subscribed before me of Sw rn to(or affirmed)and subscribed before me of
_�Ph sical Presence or Online Notarization Physical Presence or Online Notarization
this j?day of (��o�2C 2020 by this, day of C) (e,9r p ,2020 by
�O}� V`J ��NY 2•aA� �D�-14.5
Name of person making statement. Name of person making statement.
Personally Known O Pr d c e ti c rsonally Known_�_OR Produced Identification -
Type of Identification KONNI LENAE DEINITI pe of Identificati
Produced ':° Y�U�4=_ Notary Public-State of Florid oduced
KONNI LENAE DEWITf
•; Commission#GG 166915 '_�����, Notary Public-State of Florida
My Comm.Expires Dec 10,20 1 Commission#GG 166915
FoFR » '�: c10 2021
(Signature of Notary Public-S ignature of Notary Public- tatq�;llOrl�Bd�dlhraughNalionalNo(aryAssn.
Commission No. Is- (Seal) Commission No.c-�Gl 100)5- (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
516/20
COMPLETED
Rev.