HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Permit Number:
04o L�C�ICDI
0'
° M 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:
Address: 7R0C) S iJ 5 I
Property Tax ID #:
Lot No.
Site Plan Name: Block No.
Project Name: Be S� I�/eSr✓I
DETAILED DESCRIPTION OF WORK: - -
V,C� hh "Ira S HP ► aa+dr _-Gr1214M IQ
-
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
is 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:
OWNER/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-Mailchris@spanishlakes.com
from the Owner listed above)
State or County License ER 31751
If value of construction is z5oo or more, a KtGVKutu rootice oT wmmencemenL 15 Fe1LJu1FGu.
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: Applicable
Name:
_Not
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."
Signature of Ow Less bntractor as Agent for Owner
— -r
Signature of Contractor icense Ho y
STATE OF FLORIDA. C
STATE OF FLORIg�
COUNTY OFL(� �(/
COUNTY OF GUeo
The for instrum was acknowledged before me
this day of % 20� by
The forgo' g instru nt was cknowledged before me
thisay of 20z& by
ejj�l
Off'
ciz C�Lat_
Name of person making statemen
Name of person making statement.
Beverly J. Proske
Personally Known MWAWSUBMn
Personally Known ro@"Jd@mff*ation
Type of Identification STATE OF FLORIDA
Type of Identification � NOTARYPUBLIC
Produced Corran#GG262780
Produced STATE OF FLORIDA
res 9/28J2Q22
Comrn# GG262780
pares 9M/2p22
(Sig a ure of Notary c t to of Florida)
ignature r Public- State o orida )
Commission No. (Seal)
Commission o. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19