HomeMy WebLinkAboutBuilding Permit Application ALLAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �? Permit Number:
J ECEWL.,
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110.
Building Permit Application +� JUN / 8 2017
Planning and Deve/opmeniSenrites
Buffding and Code Regulafian Division #
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(7721452-1553 Fax:(772)462-1578 Commercial R �dpntial x
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID##: 3427-111-0002-000/5 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:
Additional work toe e orme un er is permit–c ec a appy:
aHVAC 13 Gas Tank []Gas Piping _Shutters Windows/Doors
R1Electric F-1 Plumbing Sprinklers 0 Generator Roof
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$—r-0 a. de) UtilitiesSewer E]Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US#1 Suite 402 Company: Laws Electric,Inc.
City: Port St Lucie State: F.L Address: 218 Beach Avenue
Zip Code: 34952 Fax: City: Port St Lucie State: FL
Phone No. 772-878-5513 Zip Cade: 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: lowselectdcinc@aol.com
*om 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: , i'Not Applicable MORTGAGE COMPANY: —V-'Not'Applicable
Name: Name:
Address: Address:
city: City.- State:
zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: –�Not Applicable 'BONDING COMPANY-. v-.NotApplicable
Name: Name:
Address. Address:
City.- City,
Zip: phone: Zip: Phone:
F
OWNER/CONTRACTOR AFFIDVIT.*Application is hereby madeto: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 wilt 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 ict or prohibit such
structure.Please consult wilth 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.
lihefollowing building permit applications are exemptfrom undergoing a full concurrency reifiew.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 pafing 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 your Notice of Commencement.
Signore of Owner/Agent/Lessee Siggo6im of Contractor/License Holder
STATE OF FLORIDA p STATE OF FLORIDA
COUNTY OF COUNTY OF-
-ibe fumoing instrurTlent was acknowledged before me The forgoing instruroent was acknowledged before me
., Of
(Marne of person acknowledging) (Name of person acknowledging
A I
(4iatuttlf Notary Public-State of Florida (S-1Fa:--tuW of notary Public-State of Florida
Personally Known. ✓OR Produced Identification Personally Known &-- OR Produced Identification
Type of Identification Produced Al2TAt. Type of Identification Produced--
PO Jdat Law
Commission N0.6c' (az 644& STATE OF F OR Onis!C1 c in p4 o.
M-NOTARYPUSUC
COMW GW 4735
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STATE OF FLOR 1:A
EgUms i it1wo2a
Expires 1111312 20
Revised 07115/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
BATE
COMPLETED
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