HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
91T° L�CIlI
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: [q PC 16 aI-/-rz
Property Tax ID #:
Site Plan Name:
Project Name: S'PCIni5A Le Kes 6-
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: ; � I
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:
Cost of Construction: $ 1,000.00
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNERAESSEE:
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 25o0 or more, a KtwKutu MOM& U. 30 1w-4--m-
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:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY: 4Not Applicable
Name:
Address:
Address:_
City:_
Zip: Phone:
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."
Signature of Owner essee/Co ractor as Agent for Owner
Signature of Cont actor/License,Holder
STATE OF FLORI
COUNTY OF_
STATE OF FLORID
COUNTY OF 1. U
The forgoing instru nt was c nowledged before me
this �/ day of 20Z( by
The for oing instru ent wasacknowledged before me
this /f� day of 20Z�by
Name of person making state ent.
Name of person making statement.
Personally Known / OR Produced Identification
Type of Identification
Produced
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of N� - jtp"orida)
NOTARY PUBLIC
Commission FLORIDkeaI)
Comm# GG262780
Aignature-
N 11fic- State of Florida )
63�y J. PAW
Commission C (Seal)
STATE OF FLORiDA
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COUNTER
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