HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPUCATION TO BE ACCEPTED 10 y 00 50
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MAY 0`2 2017
""" Building Permit Application PERf0jlTTiNG
Planning and DevelopmentSendces 5f. Lucie Cru;
Building and Code Regulation Division _
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED [NPROVEMENT LOCATION:-
Address:
OCATION:Address:
Legal Description:
PropertyTaxlD#: 1301-111-0001-00018 ?( Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack
CONSTRUCTION INFORMATION:
—Add�i' Et{iona workto epe Orme under-this permit—checka appy:
LJHVAC Gas Tank Gas Piping []Shutters ❑.Windows/Doors
QElectric Q Plumbing Sprinklers 0 Generator a Roof
Total Sq.Ft of Construction: S Ft.of First Floor_
Cost of Construction:$ J�6D< 00 Utilities: Sewer aSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US#1 Suite 402 Company: Law's Electric, Inc.
Com: Port St Lucie State:FL Address: 218 Beach Avenue
Zip Cotte: 34952 Fax: City: Port St Lucie State: FL
Phone No. 772-678-5513 Zip Code- 34952 Fax: 772-978-3347
E-Mail: Phone No. 772-971-4512
Fill in fee simple Title Holder on next page(if different E-Mail: lawselectricinc@ao€.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 LEEN LAW INFORMATION:
DESIGNERJENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Dame: Name:
Address: Address: ,
City: State- City: State:
Zip: Phone: Zip: Phone:
EEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: pe-Not Applicable
Name: Name:
Address. Address:
City: City:
11 Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
]:certify that no work or installation has commenced prior to the issuance of a permit
St Lucie Counttyy 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.
Iii 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 exemptfrom undergoing a full concurrency review:room additions,-
akcessory structures,swimming pools,fences,wails,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
commencing work or recording our Notice of Commencement.
Sign re of Owner/Agent/Lessee Sig re of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA '
COUNTY OF OF
The forgoing instrunt was prknowledged.before me The for2cing instruruerg was ackpowledged before me
this s. day of 20/ by thi>;;.2---qday of, �2* -' 'by
dr
(Name of person acknowledging) (Name of person acknowledging)
�atr of Notary Public-state of Florida) (Si ata of Notary Public-
State of Florida)
Personally Known Pl"'OR Produced Identification Personally Known i-- OR Produced Identification
Type of Identification Produced gAVAp. 701rMw T pCe of Identification Produced
G=4 o f 14 MA STATE OF 8 sion No. t�t✓rD - Juliet Law -
Commission No. •a5 NOTARY PUEA
CONO GC-Expires 1 113/2020 STATE OF FLQ A
Revised 07/15/201 F->� 11113[2
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COULTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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