HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date Y� a _2Permit Number:
M
Building Permit Application AUG 2 2 2019
Planning and Development Services
Building and Code Regulation Division P E r,11"FE!Yr I IN,G
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie COUntly, FL
Phone:(772)462-1553 Fax:(772)462-1578 Commercial- Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address: b/,,:, 4=
Legal Description:
Property Tax ID#: Lot No.
SitePlan 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 work to be ae ornted unclertnLs pennit—check all 1hal apply:
1jHVAC Gas Tank EJGas Piping "Shutters Elwindows/Doors
Electric Plumbing Sprinklers 0 Generator Roof
Total Sq-Ft of Construction: So.Ft.of First Floor;
Cost of Construction: 40. Q Sewer FISe Building Height
Utifities: ptic
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp.. Name: James W Law
Address: 8000 S US#I 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. 772-9714612
Fill in fee simple Title Holder on next page if different E-Mail- lawselectrieinc@aol.com
from the Owner listed above) State or County License: ER0000122
if value of construction is$2500 or more,a RECORDED Notice of Commencement is recruilred-
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: :E:Not Applicable MORTGAGE COMPANY: _✓Nat.applicable
a e:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: y/NotApplicable BONDING COMPANY: r/NotApplicable
Name: Name:
Address: Address•
City: City:
Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit-to do the worts and installation as indicated.
1-certifythat no work or installation has commenced priorto the issuance of a permit
5t Lucie Counttyy makes no representation that is granting a permit will authorize the permit bolderto build the subjectstructure
which is in cor�flictwith any applicable Home Owners Assopation 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_
la consideration of the granting of this requested permit,I do hereby agree that t will,in an respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St Lucie County Amendments.
Thefoliowing building permit applications are exempt from undergoing 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
itrtprovements to your property.A Notice of Commencement must be recorded and posted on the jobsit:e
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/Agentf Lessee Siggeure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY-OF� �G{��• COUNTY OF
the forgoing instru nt was before me The forgoing intro ntwas acknowledged before me
thin-,, y of � ZUf. by this-:day of,- G :4 2U by
01
(Name of person acknowledging) (Name of person-acknowledging)
( J5atur of Notary Public-State of Florida) (Si"a of Notary Public-State of Florida)
Personally Known L--"OR Produced identification Personally Knowny OR Produced Identification
Type of Identification Produced Ju1teY tP Tvpe of Identification Produced
Commission No. Cs cS :_ STATE OF OF issifln No. 'C ° •- p NOTARYPUBLIC
STATE OF R-,qExpires 11/ 312020
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'sem 9 .Expires 1111312 0
Revised 07115/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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