HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 'X- W *'2 )
Permit Number:
94 o [LUC L
O
WBuilding Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 17 San Ro r'in
Property Tax ID #: Lot No.
Site Plan Name: Block No.
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 _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction. Sq. Ft. of First Floor:
Cost of Construction: $ 1,000.00 Utilities: _ Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameWynne Building Corp Name: Christopher Jernigan
Address:8000 US 1 Ste 402 Company -.Arc Master Electric LLC
City: Port St Lucie State: _ Address:1660 SW Mackey Ave
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
Fill in fee simple Title Holder on next page ( if different E-Mailchris@spanishlakes.com
from the Owner listed above) State or County License ER 31751
If value of construction is z5uu or more, a KCt UnUCU IMULMC V1- - _
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 MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City:
Zip: Phone State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City:
City:
Zip: Phone: 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County 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 recordingour Notice of Commencement.
Signature of ner/ Lesse Contra las Agent for Owner Signature of Contr �Ctor/Lice a Hol
STATE OF FLORI / STATE OF FLORI /�►
COUNTY OF_ _ U!J I. COUNTY OF
Swor (or affirmed) and subscribed before me of Sworn (or affirmed) and subscribed before me of
Physical Preser���r Online Notarization Phhyslcal Prese#ee�or
this day of �� �J�iD Imn ti„ Online Notarization
Name of person making statement.
Personally Known / OR Produced Identification
Type of Identification
Produced ., .. /I
(sign-at:ure of KSTATEOFF1
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Commissi ORIDA
(Seal)
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:RECEIVED
ATE
DATE
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Name of person making statement.
Personally Known .� `OR Produced Identification
Type of Identification
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Commission NOTARYPUBLIC (Seal)
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SUPERVISOR PLANS VEGETATION SEA TURTLETREVIEW
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