HomeMy WebLinkAboutBuilding Permit Applicatlion All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: * is-- col`I Permit Number:
91r.[LUCHE
0
- Building 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: 3y
Property Tax ID#: Lot No.
Site Plan Name: N Block No.
Project Name: n+r UL,6 U i I
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
X 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:
OWNERf LESSEE: CONTRACTOR:
Name Wynne 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-Mail chris@spanishlakes.com
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: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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 commencin work or recording our Notice of Commencement.
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Signature of Owner Lessee/Ca . actor a��t-f6r Owner Signature of Cont ctorJlicense Ider
STATE OF FLO A ' 'A, A STATE OF FLORI
COUNTY OF L COUNTY OF (''"
Sworn to firmed)and subscribed before me of Sworn Y affirmed)and subscribed before me of
acercal Prese a or Online Notarization P ical Prese ce r Online Notarization
this day of 2021 by this day of , 202V by
Name of person maki g statement. Name of person rnak g statement.
Personally Known OR Produced Identification Personally Known y OR Produced Identification
Type of Identification Type of Ide tification
Produce4 Produce
'4' - &�4
(Signature of UaPm Iorida ) ida )
(Si nature of
OTARY PUBLIC STATE OF FLORIDA
Commissio STATE OF FLORID4Seal) Commission 62780(Seal)
Comm*GG262780
Expires OM612022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20