HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED y
Dater l r� Permit Number:Ar
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Building Permit Application JUL 2 Q 2017
Planning and DeuglopmentServices
Suffding 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 w
PROPOSED INPROVEMENT LOCATION:
Address: / --e— r
Legal Description: `
Property Tax ID#: 3414-501-1701-000/9 Lot No.
Site Plans 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 won to be erformed un er t rs perms --c eck all that appy:
E1HVAC Gas Tank Gas Piping _Shutters E]Windows/Doors
Electric 0 Plumbing FiSprinklers In Generator Roof
Total Sq.Ft of Construction: So.Ft.of First Floor:
Cost of Constructions:$/��. c t� Utilities:[:]Sewer L__.1Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law.
Address-- 8000 S US##1 Suite 402 Company: Lawn's Electric,Inc.
City: Port St Lucie State: PL Address: 218 Beach Avenue
Zip Code: 34952 Fax: City: Port SL Lucie State: FL
Phone No. 772-878-5513 Zip Code: 34952 pax: 772-878-3347
E-Mail. Phone No. 772-971-4512 -
Fit in fee simple'Tstle Holder on next page(if different, E-Mail: lawselectricinc@aol.com
from the Owner listed above) State or County License: ERQ000122
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAM INFORMATION:
DESIGNER/ENGINEER: `NotAppiicable MORTGAGE COMPANY: k-"NotApplicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: c/Not Applicable
Name: Name-
Address: Address:
City: Oty:
Zip: Phone: Zip: Phone:
OWNER]CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permitto d2 thew is O in. Was indicated.
I certify that ne work or installation has commenced priorto the issuance of a permit Can
St Lucie County makes no representation that is granting a permitwill authorizethe ermitholderto 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 consultwith your Home Owners Association and reviewyour deed for any restrictions which may apply.
In consideration ofthe 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 buiiding.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 roust be recorded and posted on the jobsite
before the first inspection.If you Intend to obtain financing,consult with lender or an attorner&fore
commencin work or recordingyour Notice of Commencement.
Sign#&e of Owner/Agentl Lessee Sig ure of Contractor/License Hold/
STATE OF FLORIDA STATE OF FLORIDA �
COUNTY OF �. ,Llr COUNTY OF
theforeoing instrurT}gntwas acknowledged before me The forgoing instrument was acknowledged before me
thm.z�y of 2D/ by thia--:&--slay of, E]2220, -by
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(Name of person acknowledging) (Name of person acknowledging)
( i atur of Notary Public-State of Florida} (Siatu of Notary Public-State of Florida)
Personally Known 91-"OR Produced Iderit ion Personally Known i-- OR Produced Identi�tion
Type of Identification Produced jullet y of Identification Produced
STATE O Fl: Juliet L9W
Commission No. 's �- C. ion No_ G�sD NOTARY PUBU
• Expires 1511312020 STATE OF FL A
Revised 07135/2014 Expires 1'111312 0
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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