HomeMy WebLinkAboutBuilding Permit Application 67/62/2615 09:23 1 ELITE ELECTRIC INC PAGE 01
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /,in ��n
Date: 07/02/2015 Permit Number: ( C3
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 x
PERMIT APPLICATION FOR: Mechanical
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Address: 9475 S Indian River Drive Fort Pierce, FL 34982
Legal Description: 19/20 36 41 S 100 ft of N 551 Ft of S 1/2 off SE 1/4 of Sec 19 Lyge of FEC RR and S 100 Ft of N 551 of
Fract Sec 20 with RIP RTS-Less FEC and RD RAN(1.41 AC)(OR 666-1569:900-2708)
Property Tax ID#: 3519-441-0004-000-5 Lot No.
Site Plan Name: Block No.
Project Name: Lois Brown
Setbacks Front Back: Right Side: Left Side:
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daitional work to be perrormed under this permit--check all appy:
HVAC Gas Tank []Gas Piping _Shutters Q Windows/Doors
11 Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. of First Floor:
Cost of Construction:$ 5438.00 Utilities: Sewer Septic Building Height:
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Name Lois Brown Name: John A Pankraz
Address: 9475 South Indian Drive Company: Elite Electric And Air
Cly. Fort Pierce State: FL Address: 1691 SW South Macedo Boulevard
Zip Code: 34982 Fax: City; Port Saint Lucie State: FL
Phone No. Zip Code: 34984 Fax:
E-Mail: Phone No. 772-340-3797
Fill in fee simple Title Holder on next page(if different E-Mail: Laurag@EliteElctricAndAir.com
from the Owner listed above) State or County License: CAC1816433
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
er/e2i'L1J1b IU:32 1 ELITE ELECTRIC INC PAGE 01 . I
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"DESIGNERIENGINEER: x Not Applicable MORTGAGE COMPANY: ±x Not Applicable ~
Name: Name:
Address: Add ress:,
City: State: City: State•
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: X Not Applicable
Name: __._ Name;
Address: Address:
City' City:
Zip: Phone: Zip. Phone:
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 sub}ed structure
which is in conflict with an applicable Homeowners 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 anV-restrictions which may apply.
In consideration of the granting of this requested permit,i do hereby agree that i will,in all respects,perforin 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 fail to Record a Notice of Commencement may result in your paying twice for
improvements to your pro .A Notice of Commencement must be recorded and posted a e lobsite
before the ' to pecti W.if you intend to obtain financing,consult w" er ar an rney before
comma n wor o ecordina vour Notice of Commencement.
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5 e-of essee/Agent Signature o contra cense Holder
STATE Ofk-&=o5., Uta t, STATE OF-
Cs+ f „ate
COUNTY OF- LM at.,
The forgoing instrume t was acknowledge fore me The forgoing instrument was acknowledged oefore me
thisa day of 20 Ljby this„p?ijJ ay of SOL 20 jjcJ by
'yohn A PanMw Jphn A Pagteax
(Name of person acknowledging) (Name of person acknowledging)
(Signature of N ary Publio•State of Flo da) (Signature of Nota Public-State of Florida)
Personally Known x OR Produced Identification Personally Known X OR Produced Identification
Type of identification Produced T e of identification Produced
"• ��,
NANCY LEE LAN FORD,
Commission No. � Y Csr,a:,,.+:°,SIGN.# ion No. ., "A CY
¢"ok EXPIRES G'•totic•-- 'I 2318 LEE i.ANGFO
EXPIRES October 12,201
Revised 07/15/2014 007 398-0ts3 rwvc s
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REViT:iN
DATE
COMPLETE
INITIALS