HomeMy WebLinkAboutLempka, Kathleen electric permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/5/22 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 Residential xx
PERMIT APPLICATION FOR: ELECTRIC
PROPOSED IMPROVEMENT LOCATION:
Address: 5413 CASSIA DRIVE
Property Tax ID #: 3402-610-0104-000-5
Site Plan Name: LEMPKA
Project Name: LEMPKA
Lot No.21
Block No. 73
DETAILED DESCRIPTION OF WORK: I
Complete 150 amp service replacement, which includes: Replace, like for like, 150 amp outdoor weather proof panel,
200 amp meter can, surge protection, large junction box to properly extend circuits from home to new panel and
update main grounding system. job will be scheduled with FPL
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
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 2423.54
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWN ER%LESSEE:
CONTRACTOR:
NameKATHLEEN LEMPKA
Name:JOHN PANKRAZ
Address:5413 CASSIA DRIVE
Company: ELITE ELECTRIC AND AIR
City: FORT PIERCE State:
Zip Code: 34982 Fax:
Phone No. 772-882-8557
Address:1691 SW SOUTH MACEDO BLVD
City: PORT ST LUCIE State: FL
Zip Code: 34984 Fax: 772-340-3702
Phone No772-340-3797
E-Mail:K8.LEMPKA@YAHOO.COM
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 Z500 or more, a KtLUKUtU NOZICe O7 LOmmencUMU11L [a Icyuucu.
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 MORTGAGE COMPANY: k Not Applicable
Name: Name:
Address: _ Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: k Not Applicable BONDING COMPANY: k 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.
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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.
Rev 1 1 1
Signature of ractor - or -Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF Sf Vic
Sworn to (or affirmed) and subscribed before me of ?� Physical Presence or Online Notarization
this �'� day of __ 20�'�'by
Name of person making statement.
Personally Known V_ OR Produced Identification
Type of Identification Produced
1
(Signature of Notary Public- State of Florida)
�CONNI LENAE DEWITT
Commission No. (Seal) Notary Public -State of Florida
Y a Commission ; HH t 65134
My Comm. Expires Dec 10, 2025
Bonded through National Notary Assn.
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