HomeMy WebLinkAboutpermit application ALL APPLI, BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date- t _-2-,4 47 Permit Number: 4/ 1 77
Building Permit Application
Planning and Development Services
Building and Code Regulation 07vislan
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address:
Legal Description:
Properly Tax iD#: 3414-501-1701-000/9 Lot No.
Site Plan Name: Block No.
Project Dame:
Setbacks' Front_ Back: Right Side: Left Side:
-DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
CONSTRUCTION INFORMA'nCN:
MOnal f
vvor to-b d-k— erformed under this permit–Check all t=apply:
ACIU8,3
HVAC []Gas Tank Etas Piping Shutters Windows/Doors
Electric Q Plumbing FSprinklers Generator E.Roof
Total Sq.Ft of Construction: So-Ft of First Floor.
Cost of Construction:$ / e) Utilities:DSewer F lSeptic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address- 8000 S US#I Suite 402 Company: Law's Electric,Inc.
City: Port St Lucie State:FL Address: 218 Beach Avenue
Zip Code: 34952 Fax: City: Part St Lucie state:.FL
Phone NO. 772-878-5513 Zip Code: 34952 , _ Fax: 772--878-3347
E-Mail: Phone No. 772-971-4512-
Fill in fee simple'ritle,Holder on next page I if different E-Mail: lawselectricinc@aoLcom
from the Owner listed above) State or County License: ER0000122
I
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNER/ENGINEER: _ZNot 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: _,/IVot Applicable
Name: Name:
Address: Address:
City. City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permitto dothe 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 apermit 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 rion-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 jobsite
:before the first inspection.If you intend to obtain financing,consult with lender or an attorney before
commencin work or recording our Notice of Commencement.
Sigrilirture of Owner/Age Lessee Si ure of Contractor/license Holder
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF d �Gf,P .� COUNTY CIF-
The forgoing
FTheforgoing instrument was acknowledged-before me Theforgoing instrument was acknawiedged before me
this /o day of t,4 P .20 thisJ0 day of eg,/i Z 20-f, -by
I(Nam persan acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
A �ROWN WALMACH
Commission No. a E BROWN WA tom{ on No.F a
Y COMMISSION 1= 984663 ••- MY 60MMISSION N FFW663
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EXPIRESAprI121 EXPIRES A0121,2020
iaorl�ao�5a RoddaNaarr9ervk.cam (407)3990153 F&k4NoWaGnwwm
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW RJENIEW REVIEW REVIEW REVIEW REVIEW
'DATE
RECEIVED
;DATE
COMPLETED
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