HomeMy WebLinkAboutBuilding Permit Application 10/28/2015 10:32 1 ELITE ELECTRIC INC PAGE 02
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: lb� l� Permit Number:
' RECEi .- OCT 2 8 NIS
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
Address: 13207 S Indian River Drive,Jensen Beach, FL 34957
Legal Description: 03741 BEG ATPTONWLYM OF OJO RNOR I42UFTSLY OF NSGRYOF SFC S.TNRUN SWLY 1FAFr.THNWLY70 FT,TH SMILYS4OFr MA.TO ELY RWFEO RR,THSELYALOSO RIW305F1M1L THNELYRWrTHN U ANO 300 FTS
ANG495FTM1,TH NWLYTOFT,THNFLY24OFTL0LTOWLYaANK OF MO RN,TH VRWa MNG 30 RNNWLY130 FTMA.TOPTLYGNELYOFPOS,TH SWLY 00 FT WL TO POG4MSRTO7-(OR420-2150:17811933:1203.1993:14431700;31211084;3731.1005)
Property Tax ID#: 4509-120-0012-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side:. Left Side:
ti' i'� `b: •l'A 'S'�'Gi'.- '2 `l^r� t g-f y'�1 $ ?�r r �,# �i� d &�h' t�YL� 4
,'� .k , , as 3 ;y; r, r+F4� ''<}i&s�1'F�f+�:,���'�S� 4 ,)1�`�t�� g. ,� `� 't't1 ;:•" �'� `t �.�
M: ,c•
Replace existing AC system with a new Rheem 1.5ton 15.5seer 5kw heater
itiona wor to e erformed uncier this permit--c eckall appy:
Z✓ HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
CElectric Plumbing Sprinklers 0Generator Roof
Total Sq. Ft of Construction: So.Ft.of First Floor.
Cost of Construction:$ $4600-00 Utilities:0 Sewer Septic Building Height:
Name Audry Rollins Name: John Pankraz
Address:13207 S Indian River DR Company: Elite Electric 8L Air, Inc
City: Jensen Beach State:FL Address: 1691 SW South Macedo Boulevard
Zip Code: 34957 Fax: City: Port Saint Lucie State:FL
Phone No. Zip Code: 34984 Fax: 772-340-3702
E-Mail: Phone No. 772-340-3797
Fill in fee simple Title Holder on next page(if different E-Mail: JessicaP@EliteElectricAndAir,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.
10/28/2015 10:32 1 ELITE ELECTRIC INC PAGE 03
DESIGNER/ENGINEER: x Not Applicable 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:
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 your paying twice for
improvements to your property.A Notice of Commencement must be recorded 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.
At�� . s
nature mer/Lessee/Agent Si ure of Co r r/License Holder
STATE O FLORIDA STATE OF FLORIDA
COUNTY OF saint Lucie COUNTY OF Saint Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 00*0122r' 20 1-5--by thisa2r day of 00&br 20 IS by
John Pankm 1 John Pankraz
(Name of person acknowledging) 1 (Name of person acknowledging)
(Signature of N tary Public-State of Flori ) (Signature of Notary/Public-State of Florida)
Personally Known_74—OR Produced Identification Personally Known /� OR Produced Identification
Type of Identification,Produced Type of Identification Produced
Commission No.L!%936a y� e NANC ommission No. 303 ea
My COM LE
/ O
Revised 07/15/2014 Flo�tloly o �@mer�2,ao�g¢2 R��ssoc�oN �OF
• ke.cp °�o O
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MAN 141
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS