HomeMy WebLinkAboutpermit app for 3 Med NAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11 -17-2_k
ST. LUCI E
CO�II,NT'Y
F L (O R 1 D A
Permit Number:
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:
Address: mi n R I vJ AI
Property Tax ID #:
Site Plan Name:
Project Name: G S 1
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 _ Gas Tank _ Gas Piping _ Shutters
)(- Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: _
Cost of Construction: $ 1,000.00
9
Lot No.
Block No.
— Windows/Doors _ Pond
Roof Pitch
Sq. Ft. of First Floor:
Utilities. —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp
Address:8000 US 1 Ste 402
City: Port St Lucie
Zip Code: 34952
State:
Fax: 772-204-2180
Phone No.772-878-3011
E -Mail: beverly@spanishlakes.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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 25uu or more, a Kt%.UMLJrU - • - _
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
-- Not Applicable
MORTGAGE COMPANY: )C Not Applicable
Name:
Address:
COUNTY OF �� L (%�
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:Not Applicable
Name:
Address:_
Name of pers'oh makin statement.
Address:
City:
Personally Known OR Produced Identification
City:
Zip: Phone:_
Type of Identificat on
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 "
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Signature Mof Contractor/ icense Hol
Signature of Owneif Lessee/Cont-for as X-lor Owner
STATE OF FLORI
STATE OF FLORI�j_
COUNTY OF �� L (%�
COUNTY OF V
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The f r ing instru nt�was ack ow dged before me
this" U
The for ng instrum t was ackno led a before me
M
of 20Z, by
this day of � by
0%r 4®l Y lCg!" X17'1 r
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Name of person niaking statement. i
Name of pers'oh makin statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identificat on
Produced
Produced
(Signature of Notary, - tate of Florida)
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(Si ature of7onsndA8WV1L0N
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Commission No. MEMOS �YttNUO012M
Commission Seal)
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REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER REVIEW REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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