HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
rA Permit Number:
Date: � � S � 1
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Building Perm 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: I
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 _ Gas Tank _ Gas Piping _ Shutters
Y Electric Plumbing Sprinklers _ Generator
Lot No.
Block No.
_ Windows/Doors — Pond
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:
Name Wynne Building Corp
Address:8000 US 1 Ste 402
City: Port St Lucie State: _
Zip Code: 34952 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)
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 z5uu or more, a KCI4VKucu IMuL116c V1- - -
if value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:_
Address:
City: —
Zip:
x Not Applicable
Phone State:
MORTGAGE COMPANY:
Name:_
Address:
City: —
Zip:
Phone:
x Not Applicable
State:
FEE SIMPLE TITLE HOLDER: x_ Not Applicable BONDING COMPANY: x Not Applicable
Name: Address: Name: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 recording our Notice of Commencement.
Signature of Ow er/ Lessee on ra �tprasAgent for Owner
STATE OF FLORJDA
COUNTY OF Z_V&.t
Swor (or affirmed) and subscribed before me of
PhOcal Presence � orr�-�;---- Online Notarization
this 1� day of �A , 2020r by
Name of person making statement.
Personally Known Produced Identification
Type of Identification
Produced /I
(Signature of Notary PM
Commission No.
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
::
DATE
COMPLETED
Signature of Contr or/License
STATE OF FLORIDA
COUNTY OF
Swor o (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this /S day of _C%fQIG, — , 202,K by
Name of person making statement.
Personally Known O PR roduced Identification
Type of Identification
ProducedA /J
IS►gnature of N u�ajt%L11orida )
NOTARY PUBLIC
Commission FLORIDA(Seal)
s CWM* GG262780
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW