HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/29/21 Permit Number:
Building Permit Application
Planning and Development services
Building and Code Regulation Division Commercial Residential XX
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: MECHANICAL
PROPOSED IMPROVEMENT LOCATION:
Address: y 1 y JAUKtiUN WAY
Property Tax ID #: 1423-802-0027-000-9
Site Plan Name: WORTH
Project Name: WORTH
DETAILED DESCRIPTION OF WORK:
REPLACE AC, LIKE FOR LIKE, 3.5 TON, 15 SEER YORK YCE42B22S, AE42CBC21, 5 KW
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
f, echanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ '741 1 • id Utilities: —Sewer —Septic
Lot No. 25
Block No.
Building Height:
Pond
Pitch
OWNERAESSEE:
CONTRACTOR:
Name EDWIN WORTH
Name: JOHN PANKRAZ
Address: 919 JACKSON WAY
Company: ELITE ELECTRIC AND AIR
City: FORT PIERCE State: rL
Zip Code: 34949 Fax:
Phone No. 772-32.1-7217
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 CAC1816433
.. vv.- V. ...l.-IM k wil 13 L7VV V1 MUltl, Q RCti.vrcuru rvoiice or commencement is regwrea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name: MORTGAGE COMPANY:
Address: Name:
City: Address:
State: City:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY:
Address:
Name:
City:
Address:
Zip: Phone:
City:
Zip: Phone:
Not Applicable
State:
Not Applicable
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 Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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
Signs ftu er oer o Ow r/ Lessee/(-ontractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF_
Sworn to (or affirmed) and subscribed before me of
this 2`1 day of SI''I)T , 2021 by �—Physical Presence or Online Notarization
Name of person makir
g a 1cMUI I1.
Personally Known k OR Produced Identification
Type of Identification Produced
(Signature
State of Florida )
Commission No. 13 ., 'vQ'• KONNILENAEDEWIT"
H (Sea mac•.
:.�: Notary Public . State of °'.orida
i= . moo ; Commission # HH t 65' 3d
?:F My Comm. Expires Dec i0, 2025
3orcec through National Notary Assr.
Notary Public
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COMPLETED
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