HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/24/21
Permit Number:
5A
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERIVIITAPPLICATION FOR:ELECTRICAL RESIDENTIAL
Address: 4200 N HIGHWAY A1A , UNIT 915, FORT PIERCE, FL 34949
Property Tax ID #: 1423-501-0167-000-8
Site Plan Name: HERRMANN, THEODORE
Project Name: HERRMANN, THEODORE
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: $ 1,496.15
X
Lot No.
Block No.
— Windows/Doors _ Pond
— Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
Name THEODORE HERRMANN'"`
Name: JOHN PANKRAZ
Address: 4200 N HIGHWAY A1A # 915 FORT PIERCE p y�
Com an ELITE ELECTRIC AND AIR
City: State: Address: 1691 SW SOUTH MACEDO BLVD
Zip Code: 34949 Fax: City: PORT SAINT LUCIE FL
860-929-2890 State:
Phone No. Zip Code: 34984 Fax: 772-340-3702
E-Mail: THERRM55@GMAIL.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 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.
,
DESIGNER/ENGINEER: x Not Applicable p
pp 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 ap attorne before commencing work or recordin our owce of Commencement.
Signature of Owner/ ssee/Contractor as Agent for Owner Signature of Contra r/License Holder
STATE OF FLORI STATE OF FLO A
COUNTY OF SAINT CIE COUNTY OF SAI LuclE
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 24TH day of DUNE . 2020 by this 24TH day of JUNE 2020 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 Iden_tifi�_ tion Type of-ldentificatiocl....
- Pr ced
_ oduced
KONNI LENAE DEWITT
Notar Public — State of Florida
(Signature of Notary Pu i% € iion�tGG 166915 (Signature of Notary Publ' S EI ri �rr��Ission
=s � 'Vlt dot: My Comm. Expires Dec 10, 2021 �y om(n. Expires Dec 10, 2021
Commission NO. GG16691 F;°' 0ond NalionalNolaryAssn.
Commission No.
GG166915 Ronde Ihrou h Na(ional Notary Assn,
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