HomeMy WebLinkAboutBUILDING PERMIT APPLICATION ALL APPLICABLE INFO MgUSTI3E COMPLETED FOR APPLICATION TO BE ACCEPTED ,,�j
Date: off' �r o2-a'l Permit Number-
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Building Permit Application
Planning and Levelopmentservices
Building and Code Regulation Division
2300 Virginia Avenue,Farr Pierce FL 34982
Phone:(772)462-1553 Fax. (772)462-1478 Commercial . Residential X
PERI'V[IT AP?L ICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION--
Address: da-6ge-, V_x-,
Legal Descripti:)m.
Propert,►Tax ID-#: 1305-11'1-0001-000!5 =?L' Lot No.
Site Plan Name: Block No_
Project Mame:
Setbacks Front i Back: Right Side: Left Side:
I
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack
CONSTRUCTION INFORMATION:
Additional work to be nertorme un ert is permit—check all apply.
HVAC _ Gas Tank El Piping _Shutters Q Windows/Doors
�E�ectric �Plumbing Sprinklers Q Generator U Roof
Tota`Sq.Ft of Construction:. 5 Ft_.of First Floor_
Cost of Canstr:ction:$ Utilities Sewer Fi5eptic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Larne Wynne Building Corp- Name: James W Law
Address: WED S US#1 quite 402 Company: Law's Electric, lnc_
City: Port St_Lucie State: FL Address: 218 Beach Avenue
Zip --ode: 34952 Fax: City: Port SL Lucie State: FL,I
Phone rJo. 772-878-5513 I Zip Code: 34952 Fax: 772-878-3347
E-Wail: I Phone No. 772-971-4512
Fill in fee simple Ttle Holder on next page(if different E-Mail: lawselectricinc@aoLcom
from tine Owner listed above) State or County Licenser ER0000122
if value of cons:-ruction is$2500 or more,a RECORDED Notice of Commencement is required:
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SUPPLEMENTAL CONSTRUCTION LIEN'LAW INFORMATION.
DESIGNER/ENGINEER: V NotApplicable MORTGAGE COMPANY: ✓Not.'Applicable
Name:
Address: j Address:
arty: State- City_ State: I
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: I/Not Applicable BONDING COMPANY: v"Not Applicable
Name: Name:
Address: Address_
City; Crty:
Zip: Phone! Zip• Phone:
OWNER)CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permitto do the work and installation as indicated.
1-certifythat no work or installation has commenced priorto the issuance of a permit-
St
ermitSt.Lude County makes no representation that is granting a permit will authorize the permit hclderto 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 consult with your Home Owners Associatibn and review your deed for any restrictions which may apply-
In consideration ofthe grantingofthis requested permit 1 do hereby agree that I% ill,in all respects,performthe.work
in accordance with the approved pians,the Florida Building Codes and St-Lucie County Amendments.
The folloi irig building permit applications are exemptfrom undergoing a full concurrency revieuu:room additions;
accessory structures,swimming pools,fences walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Yourfailure to Record a Notice of Commencement may result in your payingtwice for
iinpravetnentsto your property.A Notice of Commencement must be recorded and posted on the jobsite
.6 re the first inspection.If you intend to obtain financing,consult with lender'or an attorney before
commentingwork or-recortlin our Notice of Commencement.
Signg re of Owner/Agent!Lessee5gn urs of Cantractorf License Holder
STATE OF FLORIDA STATE OF FLORIDA L
COUNTY OF � � �(/�.r COUNTY OF_____,A
The foreoing instru t was acknowledged before me Theforgoing instru nt was acknowledged before me
thi 4; day of 2o1 by this— ds of, _ 20,67_by
(Name of person acknowledging) (Name of person acknowledging) i
( i sato of Notary Public-State of Florida I (S atu of(Votary Pubfic=state of Florida)
Personally Known OR Produced Identification Personally Known OR Produced identification
Type of Identification Produced EYP. T pe of identification Produced
C dad Law
Commission No_ �'e � STATE OF OW ssion No_ �(sO ° NOTARY Pt18lj
uYfwM GG(46M - $TATE OF FLqR I A
Expires 1 1J 1312020
Revised 07l15lZOI4 � Expires 1111312 0
REVEEXMS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE j
RECEIVED
DATE
COMPLETED
Z'd -99Z L-L99-699 LVSC8L8ZLLMVI af;b-80 LI, L0.6nV