HomeMy WebLinkAboutLeitch permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/11/21 Permit Number:
I v:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: ELECTRIC
PROPOSED IMPROVEMENT LOCATION:
Address: 13207 S INDIAN RIVER DRIVE
Property Tax ID #: 4509-120-0012-000-0
Site Plan Name: ROLLINS-LEITCH
Project Name: ROLLINS-LEITCH
Residential X
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
Supply and install a replacement 80 amp pool sub panel LIKE -FOR -LIKE. Supply and install a 60 amp GFCI breakers
for the pool heater equipment.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
/_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 933.94 Utilities: —Sewer _ Septic Building Height:
OWNER%LESSEE:
CONTRACTOR:
NameAUDRY ROLLINS OR RODGER LEITCH
Name:JOHN PANKRAZ
Address:13207 S INDIAN RIVER DRIVE
Company: ELITE ELECTRIC AND AIR
City: JENSEN BEACH State: _
Zip Code: 34957 Fax:
Phone No.804-513-8777
Address:1691 SW SOUTH MACEDO BLVD
City: PORT ST LUCIE State: FL
Zip Code: 34984 Fax: 772-340-3702
Phone N0772-340-3797
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
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
Name:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: X Not Applicable
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 your Notice of Commencement.
Signature of G11kner/ Lessee/Contractor as Agent for Owner Signature of Contra c r/License Holder
STATE OF FLORIDA
COUNTY OFST LUCIE
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
this day of , 2020 by
JOHN PANKRAZ
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced
(Signature'bfN'otary Public- State of
KONi I LENAE DEVI
Commission No. GG166915 2�`- {)Notary Public-Skaieof
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REVIEWS
DATE
RECEIVED
DATE
COMPLETED
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COUNTER REVIEW
STATE OF FLORIDA
COUNTY OFSTLUCIE
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
this day of 2020 by
JOHN PANKRAZ
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced
ture oTN—otary Public -
pm Isslon No. GG166915
2021
Assn.
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Commission # GG 1669
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SUPERVISOR I PLANS VEGETATION S
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