HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: g- ( I .-, l Permit Number:
oU
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:
X
Address: q L lq u ar l-e G� -
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
X Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction: _
Cost of Construction: $ 1,000.00
_ Gas Piping
_ Sprinklers
Lot No.
Block No.
Shutters _ Windows/Doors _ Pond
Generator
Sq. Ft. of First Floor:
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNERf LESSEE:
CONTRACTOR:
Name Wynne Building Corp
Name: Christopher Jernigan
Address:8000 U3 1 ate 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 RECORUEU NOLIce oT i-ommencemem; is requires.
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:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
Address:
City:_
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
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."
SignatILA�wner/essee4/Co ractor as Agent for Owner
Signature of Contractor/Licensed folder -
✓✓
STATE OF FLORIP
COUNTY OF I�UGy e
STATE OF FLORID
COUNTY OF �C U e /
The forgoing instrurvpnt wa c nowledged before me
this // day of 20& by
The for oing instru ent was cknowledged before me
this �t� day of 20Z�by
Name of person making state ant.
Name of person making statement.
Personally Known / OR Produced Identification
Type of Identification
Produced
Personally Known /OR Produced Identification
L
Type of Identification
Produced
(Signature otNr'- jt "orida)
PUBLIC
CommissionFLORIDkeal)
Comm# GG262780
ignature of N r u lic- State of FloridaNOTARY
Bsverly J. Proske
Commission BUG (Seal)
STATE OF FLORIDA
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VE ATIgVe
REVIEW
IR1E
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.2/7/19