HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: _
° ° 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: II S_L Illy� nab
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name: LAk`s Cc)Unwv Cl c4 6 V< <1e--
[ DETAILED DESCRIPTION OF WORK: I
Replace old exisiting meter center with a new meter/main combo panel.
New Electrical Meter _X_—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
�_ 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: 34963 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)
j State or County License ER 31751
if value of construction is 25o0 or more, a KtCUKutu Notice or 4orrmmencemen1 IZI Feyufcu.
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."
N IL
Signature of O er/ Lessee/ , tractor as,Ag nt for Owner
Signature of Contractor tense Hold
STATE OF FLOR /'`' `
COUNTY OF_ 31'
STATE OF FLORIDp�L /
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COUNTY OF
The for ping in ent was knowledged before me
this day ofn�=�1 20?( by
The for ing inst n was ck ow edge b fore me
7day W 9 t
this of
Name of person making s ment.
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Personally Known OR Produced Identification
Type of Identificatio
Produce
Produced
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Signature of 15 h Ida
(ignature of TAW"j&rida )
STATE OF FLORIOA)
Commission GG26278f�Seal)
STATE OF FLORIDA
Commission ! (Seal)
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262780
Expires 9/26M22
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 211119