HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9- 2LI - a® Permit Number:
Q U WORM, w0c" p
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
W
Address: Iy L4145 bo•1i a Ave.
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name: Fe,! r W o.Y 5
I DETAILED DESCRIPTION OF WORK:
Replace old exisiting meter center with a new meter/main combo panel.
New Electrical Meter
Second Electrical Meter
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit– check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
X Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 1,000.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNERf LESSEE:
CONTRACTOR:
Name Wynne Building Corp
Name: Christopher Jernigan
Address: 8000 US 1 Ste 402
Company:Arc Master Electric LLC
Address: 1660 SW Mackey Ave
City: Port St Lucie State: _
Zip Code: 34952 Fax:772-204-2180
City: Port St Lucie State: FL
Phone No. 772-878-3011
Zip Code: 34953 Fax: 772-204-2180
E-Mail:beverly@spanishlakes.com
Phone N0772-708-9466
E -Mail chris@spanishlakes.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License ER 31751
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
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:
Address:
MORTGAGE COMPANY: )c Not Applicable
Name:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: �C Not Applicable
Name:
Address:
BONDING COMPANY: y Not Applicable
Name:
Address:
City:_
Zip: Phone:_
City:
Zip: Phone:
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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Z:-:::—�—
Sigri-aiiTre_oT O er/ Lessee/ ontracto Agent for Owner Signature of Co ractor/Lice Hold
STATE OF FLORIDA STATE OI
COUNTY OF 7 COUNTY OF lc,_ /low
The for ing instrume t was a knowledged before me The forgoing instrumerA was ack owledged before me
this day of RU&J 20M by this Z1 day of , 20by
Name of person making statement. Name of person making statement.
Personally Known `� OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(S' nature of N F
Gditrida) (ignature of No I a
BLIC (IdCommission LORI NOTARY PUBLIC
mal) Commission N FFLOR&al)
62780Comm# GG262780
REVIEWS FRONNING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Te -v--27.