HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
B',�_II tJ E 0
Building Permit Application MAY 0 2 2017
Planning and Development Services PERFY1lTT1i-k3G
Building and Code Regulation Division St. Lucie County, FL ,
2400 Virginia Avenue,Fort Pierce FL 34.982
Phone:(772)462-1553 Fax: (772)452-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION..--
Address: -
Legal Description:
Property Tax ID#• '1301-191-0001-00015 ? L Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: LeftSide:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack
CONSTRUCTION INFORMATION:
Additional work to be oertormed under this permit—check all appy:
n
LJHVAC C GasTank ❑Gas Piping _Shutters ❑Windows/Doors
1_l Electric 0 Plumbing Sprinklers 1:1 Generator a Roof
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ Sao, 06 Utilities:0Sewer FISeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US##9 Suite 402 Company: Law's Electric, Inc.
Port St Lucie State:FL Address: 218 Beach Avenue
Zip Cotte: 34952 Fax: City: Port 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 Title Holder on next page(if different E-Mail: lawselecbicinc@aol.com
from the Owner listed above} State or County License: ER0000122
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERfENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER A.,, Not Applicable BONDING COMPANY- 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.
Thefollowing building permit applications are exemptfrom 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 jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencinR work or recordingyour Notice of Commencement.
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Signirture of Owner/Ag t/Lessee Si lure of Contractor/License Holder
STATE OF FLSTATE OF FL
COUNTY OFORIDA ' �t f COUNTY OF ORIDA ' 2
CZZ
The forgoing instrument was acknowledged_before me The forgoing instr entwas acknowledged before me
this,,A.'day of 20 by this��day of 20_LZ._by
(Name person acknowledging) (Name of person acknowledging)
464tITIL& 0.�—t a— &V
(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
Commission No. / NNE BROWN WAt ssian No.f •'`rr; A�N4ROWN WALMACH
;o? a Y COMMISSION 7{F 984669 '~ COMMISSION#PF984063
EXPIRES April 21 EXPIRES April 21,2020
(407)398-0169 FlaldaNatrrrServiee.00m (407199&0131 FlaiG�F! ,eon
Revised 0711512014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVEDL
DATE
COMPLETED
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