HomeMy WebLinkAboutBuilding Permit Application ALL APPUC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: , aw—,. C�.�4?017 Permit Number:
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RECEIVED
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Building Permit Application AUG 2 8'2W
Planning and Development Services
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue,Fort Pierce FL 34982 St.Lucie County, FL
Phone:(772)462-1553 Fax:(7n)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID#: 130111'1-0001-0001.0 c 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 war tobbene rtormed under this permit—check all t=apply.
HVAC LJ Gas Tank FGas Piping Shutters DWindows/Doors
gElectric Plumbing OSprinklers 0 Generator DRoof
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 4/ Utilities:0Sewer 01
Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
.Name Wynne Building Corp. Name:, James W Law
Address. 8000SIJS,#1 Suite 402 Company: Law's Electric, Inc.
City: Port St Lucie State: FL Address: 218 Beach Avenue
Zip Code: 34952 Fax: City: Port St.Lucie State. FL
Phone No 772-878 513 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: lawselectiicinc@aot.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 required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION':
DESIGNER{ENGINEER Not Applicable MORTGAGE COMPANY: e�Not.applicable
1Varrle: a e:
Address: Address:
City: State- City: State:
Zip Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _/Not Applicable BONDING COMPANY: r/NotApplicable
Dame: Name:
Address: Address:
City: C,tty-
Zipz Phone: Zip-- Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permitto do the work and installation as indicated.
1 certify that no work or installation has commenced priorto the issuance of a permit
5t Lurie County makes no representation that is granting a permit will authorize the permit holderto build the subject structure
which is in conflict with anj applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure Please consult w th your Horne Owners Association and review your deed for any restrictions which may apply_
In considwzdan of the granting of this requested permit,l do hereby agree that 1 will,in all respects,perform the work
tri accordance with the approved plans,the Florida Building Codes and St Lude County Amendments.
The following building permit applications are exemptfrom undergoing a full cancurrencyreview:room additions;
accessory structures,swimming pools,fences,wails,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 properly-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 recording Vour Notice of Commencement.
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of Owner/Agent/Lessee Sig re of Contra ctor/License Holder
STATE OF FLORIDA - STAVE OF FLORIDA
COUNTY OF -6-1COUNTY OF
The foreoing instrurry t was a_;knowledged before me Theforeoing instruirtentwas acknowledged before me
this}, day of 201_1 •by this -day of, 4 20/-` 6y
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(Name of person acknowledging 1 (Name of person acknowledging)
1 •
.lsW atur of Notary Public-State of Florida) {Si atu of Notary Public-State of Florida}
Personally Known ✓OR Produced Identification Personally Known !--� OR P=roduced Identification
Type of Identification Produced _Type of Identification Produced
Ft
t3Li0 Juliet Law
Commission No. (s d _ STATE fission No. GG--p 6 1a NOTARYPLIBI.I
Expires?�/ 3lZ820 M STATE OF FLq A
GroWERS
Revised 07/15/2014 - 'tce _ Expires i 111312 0
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECI_iV ED
PATE
COMPLETED
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