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ALL APPLICABLE.INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 6Y CS 7
RECEIVED
Building Permit Application
Planning and Development Services JUN 0 3 ?09n
Building and Code Regulation Division
Permitting Depar,,.
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential x St. �ucte
PERMIT APPLICATION FOR: Electrical
PRO POSED'IMPROVEMENT LOCATION:
Address: 18 OVTAVIO
Legal Description: "EAST 1/2 OF SECTION 1 -TOWNSHIP 348-RANGE 39E .
Property Tax ID#: 1301-111-0001-000-5 Lot No.
Site Plan Name: COUNTRY CLUB VILLAGE Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION..OF WORK: - . _ _
INSTALLATION OF LECTRIC METER SERVICE br3'1G� ,
.:CONSTRUCTION"INFORMATION:
Additional work toe nartormed under this permit—check a appy:
OHVAC Gas Tank E]Gas Piping _Shutters a Windows/Doors
Electric ❑Plumbing Sprinklers ElGenerator 0 Roof
Total Sq.Ft of Construction: S�Ftj of First Floor:
Cost of Construction:$ 200.00 Utilities:nSewer El Septic Building Height:
OWNER/LESSEE CONTRACTOR:
Name WYNNE BUILDING CORP. Name: ALAN WALTON
Address:8000 SOUTH US HWY. 1 -SUITE 402 Company: FLORIDA STATE ELECTRIC
City: PORT ST.LUCIE State:FL Address: 751 16TH AVE.
Zip Code: 34952 Fax:(772)878-7656 City: VERO BEACH State: FL
Phone No.(772)878-5513 Zip Code: 34962 Fax:
E-Mail: Phone No. (772)539-1574
Fill in fee simple Title Holder on next page(if different E-Mail: floridastateele@gmaii.com
from the Owner listed above) State or County License: 27267
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
:SUPPLEMENTAL:CONSTRUCTION ,LIEN LAW fNFO.RNIATION:.
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:Yourfailure 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 wit rider or an attorney b
commeDeftvmrkor-=o,rdiurNotir,cvf Commencement
s
_Sign ur Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF S;. "tit& COUNTY OF 5-1— "L!e-
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this oR day of Tc.errc 20 Eby this a day of Tc,crue 20,9-Q by
ALAN WALTON 1 ALAN WALTON
(Name of person acknowledging) (Name of person acknowledging)
l
(Signature of Not ublic-State of Florida) (Signature of Nota , blic-State of Florida
/ )
Personally Known ✓ OR Produced Identification Personally Known v/OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission N DOROTHYAN IN Commission No. ::�:_� DOROTHYA09 IN
MY COMMISSION GG 30145 f MY COMMISSION#GG 030145
i' r'<= EXPIRES:OCto�t 2,2020 I 'g EXPIRES-
Bonded ThN Ncary u o,• Bonded Thru Notary Pubric underwriters
Revised 07/ f
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