HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9-'II -'D I Permit Number:
a
�o"C",
gv�*
D n
ivyBuilding 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: 91 Lr, (I e T
Property Tax ID #:
Site Plan Name:
Project Name: (:c%'ntr � C� (KD V, I ( eN! r
Lot No.
Block No.
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
k 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:
O NERAESSEE:
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 KELVKutu Notice or Lommencemen1 no m4uut:
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: State:
Zip: Phone
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 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."
r
SignatJL"QgegL/Cof Ownessee ractor as Agent for Owner
Signature of Con actor/License,W older -
STATE OF FLORI
COUNTY OF I�UGI
STATE OF FLORIDA., !
COUNTY OF
L U
The folding instru nt a �cJsnowledged before me
this // day of 20Z( by
The for oing instru Went was cknowledged before me
this �? day of 20Z(by
Name of person making state ant.
Name of person making statement.
Personally Known / OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Z LAW III
(Signature of N r Jt� orida)
�NMTARYPILIIBUC
ignature of N r u ic- State of Florida )
Commission FLORIDkeal)
E3uerly J. Proske
Commission NOTARY Of -BUC (Seal)
Comm# GG262780
STATE OF FLORIDA
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VE ATIgWre
A RLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.