HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED � ^
Date.
W!'Lf+;.- � 7 023 Permit Number.
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- ' ' Building Permit Application JUN a 5 2017
Planning and DevelopmentServices F�Ei?tll7i�hta
Budd}ng and Code Regulation Division
.2300 Virginia Avenue,Fort Pierce FL 34982 5f. Lucie C,aUnh, FL
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical Q
PROPOSED INPROVEM ENT LOCATION:.
Address:
Legal Description•
Property Tax 1 D#: 3414-501-1701-00019 Lot No.
Site Pian Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION 6F WORK:
Replace meter center with a combo pack
CONSTRUCTION INFORMATION-.
Mona wor to e erformed utier this permit—Check a appy:
HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric M Plumbing Sprinklers Generator Roof
Total Sq,Ft of Construction: SO.,FFtt.1 of First Floor:
Cost of Construction:$ „�( Utilities:#�I Sewer L 1 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Andress: 8800 S US#1 Suite 402 Company: Laws 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: lawselectdcinc@aol.com
from the owner listed above) State or County license: ER0000122
if value of construction is$2500 or more,a REWRDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERIENGINEER: Not Applicable MC)RTGAGE COMPANY: ✓Not lkpplicable
Name: Name:
Address: Address:
City: State: City: state:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Rf hwot Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVTI-;Application is hereby made to obtain a pprmitto do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit
5t Lucie County makes no representation that is granting a permitwiil authorize the permit holder to build the subject structure
which is in eorrllictwith any applicable Home Owners Association rules,bylaws or and covenantsthat may restrict or prohibit such
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structure.Please consult niyour Home Owners Associatibn and review your deed for any restrictions which may apply_
In consideration ofthe granting of this requested permit,I do hereby agreethat I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St Lucie County Amendments-
Thefoiloudng building permit applications are exempt from 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 jobs"rte
before the first inspection_ If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording ur Notice of Commencement.
Sign re of owner/Agent/Lessee SlSqKfure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA `
COUNTY OF COUNTY OF
the foreoing instrurWt was acknowledged before me Theforgoing instrumnentwas acknowledged before me
thi ay of r+ � - , Q/ by this -flay of, z Tll.,sr 4_ 20 by
(Name of person acknowledging)
(Name of person acknowledging)
- A-,CA;;� -
(S atur of Notary Public-State of Florida) (Silhffat-uh of Notary Public,-State of Florida)
Personally Known &----'OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced m Ju Taw Type of ldentificatlon Produced
NOTARY � �+ --3uliet Law
Commission No- �� STATE OFF Offl0nissionNo. fTQ .j, NOTARYPLIS
COIN 735 - STATE OF i=LR A
Revised 07/I5120I4 • • -. '�E F-��1111312 0
1
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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