HomeMy WebLinkAboutBeltone Hearing permit APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/26/21 Permit Number:
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 X Residential
PERMIT APPLICATION FOR: ELECTRIC
PROPOSED IMPROVEMENT LOCATION:
Address: iuu4z U.b. HWY 1 OR 10000 U.S. HWY 1
Property Tax ID #: 3414-501-3715-050-9
Site Plan Name: BELTONE
Project Name: BELTONE
DETAILED DESCRIPTION OF WORK:
EMERGENCY JOB SCHEDULED WITH FPL FOR 2/2/21 - REPLACE 125 AMP, LIKE FOR LIKE
THIS IS IN A COMMERCIAL PLAZA - BELTONE HEARING AID
CUSTOMER CURRENTLY HAS NO A/C DUE TO ELECTRICAL AND BURNT UP PANEL
New Electrical Meter Second Electrical Meter
Lot No. 15
Block No. 3
CONSTRUCTION INFORMATION: -- I
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
XElectric _ Plumbing _Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2075.22 Utilities: —Sewer —Septic Building Height:
OWNERf LESSEE:
CONTRACTOR:
Name EXCELLENT LAND HOLDING, INC - PLAZA OWNER
Name: JOHN PANKRAZ
Address: 10000 U.S. HWY 1
Company: ELITE ELECTRIC AND AIR
City: PORT ST LUCIE State: rG
Zip Code: 34952 Fax:
Phone No. 772-337-0102
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
_-__ __-_.._-._ .. „r. IVUubC v1 wrnmencemeni is requlrea.
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
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.
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 our Notice of Commencement.
Signature of Ow er/ Lessee/Contractor as Agent for Owner
Signature of Con actor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST LUCIE
COUNTY OF ST EUCIE
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 26 day Of JANUARY 2021 by
this 26 day of JANUARY 202p 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
Produced
Pro
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