HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I n- l i- a p—
Permit Number:
X40 LUC E -
° Building Permit Application
Planning and Development 5ervices
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•
Address: �- -
Property Tax ID #:
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace old exisiting meter center with a new meter/main combo panel.
New Electrical Meter Second Electrical Meter.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
Mechanical
Electric
Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1,000.00
OWNERAESSEE:
Name Wynne Building Corp
Address:8000 US 1 Ste 402
X
Lot No.
Block No.
_ Gas Piping _ Shutters — Windows/Doors _ Pond
—Sprinklers _ Generator _ Roof Pitch
Sq. Ft. of First Floor:
City: Port St Lucie State:
Zip Code: 34952 Fax:772-204-2180
Phone No. 772-878-3011
E -Mail: beverly@spanishlakes.com
Utilities: —Sewer _Septic Building Height:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Christopher Jernigan
Company:Arc Master Electric LLC
Address: 1660 SW Mackey Ave
City: Port St Lucie State: FL
Zip Code: 34953 Fax: 772-204-2180
Phone N0772-708-9466
E -Mail chris@spanishlakes.com
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:
City: State:
Zip: Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: _
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
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."
PA
Signature of Ow er/ Lessee/Con ctor a fent for Owner
STATE OF FLORIDA �v 4
COUNTY OF r �J'`
The for oing instrum nt acknowledged before me
this day of 2Q�/ by
Name of person making statement.
Personally KnownOR Produced Identification
Type of ldentificati
Produced
re
Commission
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NOTARY PUBLIC (Seal)
STATE -BF FLORIDA
Ccmff it GG262780
Signature of ContrKtor/Lice
STATE OF FL, M �,J�.!
COUNTY OF
The forgoing ins tru e t as acknowledged b fore me
this May of 20My
Name of person making statement.
Personally Known (z� OR Produced Identification
Type of Identification
Produced
nature
Commission
NOTARY PUB
CTA' — OF FLO
Comm# PUBLIC
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