HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:�. 1a i ,�?— /¢�T Permit number.
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Building Permit Application' AUG 11 2017
Planning and Development Services
Building and Code Regulation Division
23400 Virginia Avenin„Fart Pierce FL 84982
Phone:(772146Z-1553 Fax:(772)4621578 Commercial Residential X
PERMIT APPLICATION FOR. Electrical 0
PROPOSED INPROVEMENT LOCATIom.:-
Address: ?
Legat Descflption: .
Property Tax ID#: 3414-4501-2701-00019 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
CONSTR ICTION INFORMATION: .
nnmona won to e e edunder as permit— eta appy:
11HVAC Gas rank Gas Piping _Shutters Windows/Doors
LJ Electric Plumbing Sprinttters �Generator Roof
Total Sq.Ft of Construction: Sa.Ft.of First Floor:
Cost of Construction:$ f ? Utilities:FSewer Fleptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. . Name: James W Law
Address: 8000 S US#9 Suite 402 Company: Laws Electric, Inc.
Port St Lucie State:FL Address: 718 Beach Avenue
Zip Code: 34952 Fax: city: Part St Lucie State: FL
Phone No. 772-878-5593 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: lawsetecWcinc@aoi.com
from the Owner listed above) State or County License: ER04J00122
tf.value of construction is$2SOD or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFOWATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: elNot.Applicable
Mgme:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: r/Not Applicable
Nance: Name:
Address: Address:
City: city,
Zip: phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permitto do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St Lurie County ma kes no representation that is granting a permit will 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 or prohibit such
structure.Please consult with your Horne 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.
The following building permit applications are exemptfrom 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 payingtierice for
irhprovements 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 recordingyour Notice of Commencement.
Sign re of Owner)Agent/Lessee Sigr
#6re of Contractor/License Holder
STATE OF FLORIDA - STATE OF FLORIDA
COUNTY OF COUNTY OF
Theforeoing instrurrp?n was agknowledged before me The forgoing instrument was acknowledged before me
this-&.day of 20 by 20,
(Name of person acknowiedging) (Name of person acknowledging)
( r atur of Notary Public-State of Florida) (Si atu of Notary Public-State of Florida)
Personally Known ✓DR Produced Identiification Personally Known r✓ OR Produced Identification
Type of Identification Produced ti P T pe of Identification Produced
Es= !'� STATE OF O _ .. NOTAJuad RY PiIBLI
Commission No. ission No. GCsO
a UOMM STATE OF FLR A
Expires 11 312020
Revised 07/15/2014 ' . 11113[2 0
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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