HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 1-10-22All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: L- t 0 - Oa - Permit Number:
Building Permit Application
Planning and Development Services X
Commercial Residential
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: _S a_��--.�
Property Tax ID #: Lot No.
Site Plan Name: Block No,
Project Name: L ��^} Chu 6 —
DETAILED DESCRIPTION OF WORK: 1
Replace old exisiting meter center with a new meter/main combo panel.
New Electrical Meter__ Second Electrical Meter_
C
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters J Windows/Doors _ Pond
z Electric `. Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor;
Cost of Construction: $ 1,000.00 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
Oty; Port St Lucie State; Address:1660 SW Mackey Ave li
Iw 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
s .comanishlakes
i Fill in fee simple Title Holder on next page if different � E-Mail Chris @ P I
4 from the Owner listed above) State or County License ER 31751
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If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
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: g Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _X_ 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."
Signs ure of Owner/ ssee/Contr or or Owner
Signature of Contra or/License er
STATE OF FLORIDA l -
COUNTY OF �7 jj(f(,(�{,
STATE OF FLORIDA,
COUNTY OF_ C�
The for�Qing instrumei t was a5 n ledged before me
this �!/ day of / 0 ZZby
The forgoing instrum nt was acknowledged before me
this � day of 20 Eby
Name of person making state_wticsfit.
Name of person making statement. -
Personally Known OR Produced Identification
Personally Known .-----OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Snature of No I ke%%Wg. pkyWida)
ure of No u dWorida )
NOTARY PUBLIC
Commission T IFFLOR(W1)
NOTARY PUBLIC
Commission TEOFFLORID4Sea1)
Comrrrl« G0262780
Ca�rn* GG262780
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DATE
RECEIVED
DATE
COMPLETED
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