HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (�
Dater �, o`�C��`l Permit Number: v
Building Permit Application JUN 0 5 29.1
Planning and DevelopmentServices
Building and Code Regulation Division PEP,:viIT.i�1C
2300 VI'rginiaAvenue,Fort Pierce FL 34982 St. Lucie Count,,, FL
Phone:(772)462-1553 Fax:{772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION..-
Address:
Legal Description:
Property Tax ID## 1301-11 1-0001-000!5 ? (: Lot No.
Site Plan Name: Block No_
Project Name:
Setbacks Front Back Right Side: Left Side:
DETAILED DESCRIPTION OF WORKt.
Replace meter center with a combo pack at each address
CONSTRUCTION INFORMATION:
Mona worK to Me gerformecl under tispermit—check all ttlat appy:
HVAC - Sas Tank QGasPiping _Shutters Windows/Doors
Electric LJ Plumbing Sprinklers E Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction: Utilities SewerEl Septic 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.
city: Port St. Lucie State: FL 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: 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:
DESIGNERIENGINEER: Not Applicable MORTGAGE COMPANY: Pf"Noi A-pplicable'
Name: Name:
Address: Address:
City-- State: City: state:
ZIP: Phone: Zip: Phone:
---,
FEE SIMPLE TITLE HOLDER: Not Applicable' B-ONDING COMPANY-. v*'Not Applicable
Name: Name:
Address: Address:
c7rty-"
ZIP; Phone: —
Zip:_ Phone:
OWNER/CONTRACTOR AFFIDVrr-.Application is hereby madetD obtain a permit to do the worts and installation as indicated.
I'certifythat no work or installation has commenced priorto the issuance of a permit.
St LuclejZounty makes no representation that is granting apermit will autharizethepermit holderto build the subject structure
Which is in contlictwith any applicable Home Owners Association rules,bylaws arand covenantsthat may restrict or prohibit such
structure.Please consult with your Home Owners Associatibn and review your deed for any restrictions which may apply-
lfi 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 roams and accessary 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
c ommencing work or recordinavour Notice of Commencement.
Sign re of Owner/Agentf Lessee S1gq4?u-re of Contractor/Ucense Holder
STATE OF FLORIDA STATE OF FLORIDA
tOUNTYOF_ COUNTY OF A!
The foreafrig instruff)gntutas p;knowledged before me The forizoing instrument was acknowledged 4efore,me
�Q/ by thla..��-dayr� 20,47rby
(Name of person acknowledging) (Name of person acknowledging)
ISalar Wof Notary Public-State of Florida j (Sikffa-fu%of Notary Public-State of Florida
.Personally Known ✓OR Produced Identification _ Personally Known v' OR Produced Identification
Type of Identification Produce -AAML6. JURTUNType of Identification ProducedL_
NOTARY PO 0P J"Law
AE ,
Commission Na.C=6L45-4&zz-1r STATE OFF OROffic;,-0
ssion No. 60-6 7 C
NOTARY PU
-OBLIC
STATE OFFLIR A
Exp[mit 111.34M20 ---ffd a
M 20
Revised 07115/2014 ExpiMS1111
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED_
DATE
COMPLETED
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