HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 25 � ,oW117 Permit Number: 170,
Building Permit Application RECERW
Planning and DevelopmentServices MAY 6 �oj�
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-9.578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address:
Legal Description:
PropertyTax ID#: 1306-111-0001-00014 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 at each address
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all t=apply:
HVAC E Gas Tank ❑Gas Piping LJ OGenerator
Shutters E]Windows/Doors
Electric Plumbing Sprinklers Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ / fie o. U CC) Utilities: Sewer Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US#1 Suite 402Company: Law's Electric, Inc_
City: Port SL Lucie State:F- Address: 218 Beach Avenue
Zip Code: 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: lawselectricinc@aol.com
from the Owner listed above) State or County License: E:R0000122
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required_ V
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SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
r
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: w"Not.'•Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: I/Not Applicable BONDING COMPANY: v kot Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFROVIT:Application is hereby made to obtain a permitto do the work and installation as indicated.
]'certify that no worts or installation has commenced prior to the issuance of a permit
St.Lucie Counter 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 andcovenantsthat 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 ofthe granting o€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;
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARDING 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 worst or recordingVquir Notice of Commencement.
Sign re of Owner!Agent/Lessee Sig re of Conti-actor/license Holder
STATE OF FLORIDA pp// - STATE OF FLORIDA
COUNTY OFF� I .f.£.P.r COUNTY OF
The forgoing instrurrlentwas acknowledged.before me The forgoing instrument was acknowledggd before me
thi%Z,I�lay of .2Q4=.by th . --day of, t4�, 2O by
(Name of person acknowledging) (Name of person acknowledging)
( afar of Notary Public-State of Florida) CsikrigfuN of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known i--- OR Produced identification
Type of Identification Produced JWff-M Type of Identification Produced
NOTARY P0 or, ..•Juliet Law
Commission No-
STATE OF ORlftnissionNo. �f~s0 NOTARY PUBLIC
Gast 7M STATE OF FLIRR I A
Expirm Ili 3nox 60364m;
Revised 07/15/2014 ^` _ Expires 111131 o
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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