HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
Permit Number:
Building Permit Application
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 S V; (1A /1% o rtc_
Property Tax ID #: Lot No.
Site Plan Name:
Project Name: S�!5h lra k.e:_�� rv__ dub V � � �aa e—
DETAILED DESCRIPTION OF WORK:
Replace old exisiting meter center with a new meter/main combo panel.
New Electrical Meter. is Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Block No.
—Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors _ Pond
jC 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
City: Port St Lucie State: FL
Zip Code: 34952 Fax:772-204-2180
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
State or County License ER 31751
I
from the Owner listed above)
if value of construction is 2500 or more, a RECORDED Notice of Lommencement Is requirea.
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 Oses 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."
1
Signature of O er/ Lessee/co6tractor asAg6t for Owner
Signature of Contractor cense Hold, -
STATE OF FLORPf
COUNTY OF �i(%
STATE OF FLORIDAnL /
37` /
COUNTY OF JJT [� (J
The for oing in ent was knowledged before me
this _4 day of � 7 20� by
The for oing instP'r7t n was ck tow edge b fore me
this � day �y
of 20
Name of person makings ment.
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Personally Known OR Produced Identification
Type of Identificat?
-io
Produc
Produced
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Signature of ZS+tRfi�Rlil#I1�3ida)
ignature of T, ilpg rids )
STATE OF FLORIDA
Commission GG-2W8gSeal)
STATE OF FLORIDA
Commission (Seal)
Expires 9/M022
262780
Expires WX/2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 211119