HomeMy WebLinkAboutBuilding Permit Application ALL P PPUCABLE INFO VALIST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: __2 7� � Permit Number:
RECEIVED
�� Building Permit Application' OCT 2 7 2017 !
Planning and Development Services F
j I Eudding and Code Reguiation Division PERMITTING �
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2303 Virginia Avenue,Fort Pierce F1349$2 St. Lucie County, FL
1 Phone:(772)462-1.553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION '=OR: Electrical
PR:�POSED INPRO`1EMENT LOCATION:
Address:
c Legal Description:
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Property Tax ID#. 3414-501-1701-000/9 Lot No.
Site Pian Name: Block No.
Project Plame:
Setbacks Front Back: Right Side: Left Side:
{ DETAILED DESCRIP i iON OF WORK:
Replace meter center with a combo pack
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CONSTRUCTION INFORMATION:
''i cna work to (ee Forme under tis permit—check a t appy:
1_11�VA LJ Gas Tank ❑Gas Piping _Shutters Windows/Doors
Vectric Plumbing Sprinklers Generator a Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cos`cf Construction:$ _��y�, e.�)Q Utilities: Sewer I Septic Building Height:
01AINEWLESSEE: CONTRACTOR:
j Name Wynne Building Corp. Name: James W Law
119 I Address: 800C S US# 1 Suite 402 Company: Law's Electric, Inc.
c City: Port St Lucie State: FL Address: 218 Beach Avenue
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Zip Code: 34952 Fax: City. Port St Lucie State: FL
}I Phone No. 772-878-5513 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No. 772-971-4512
-ill in fee simple Title Holder on rnaxc page(if different E-Mail: lawselectricinc@aol.con-.
-Tars t:ie Owner listed above) State or County License: ER0000122
it If value ai construction is X2500 or more,a RECORDED Notice of Commencement is required.
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£•d -89Z 6-199-695
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: r/Not!lpplicable
ame:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FFE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: r.�Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNERI CONTRACTOR AFFIDVIT:Application is herehy made to obtain a permit to do the work and installation as indicated.
I terrify that no work or installation has commenced priortothe issuance of a permit
St Lurie County makes 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 Home 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 fallowing building permit applications are exempt from undergoing a full concurrency review:room additions;
accessory structures,swimming pools,fences,walls,signs,screen roams and accessory uses to another non-residential use
WARNING TO OWNER:Yourfailure to Record a Notice of Commencement may result in your paying twice for
improvements 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
com:Tiencinp,work or recordingVour!Notice of Commencement.
Sign4 re of Owner/Agent/Lessee Sig ure of Contractor/Ucense Holder
STATE OF FLORIDA STATE OF FLORIDA '
COUNTY OFAf COUNTY OF a
The foreoing instrumept wa a_sknowledged before me The forgoing instru w acknowledged before me
this;.' day of ZO/. by this day of,
(Nance of person acknowledging) (Name of person acknowledging)
1.
r
(Sigrrtur of Notary Public-State of Florida} (Si a0e of Notary Public State of Florida)
Personally Known ✓OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Producediuuet_thype of Identification Produced
IICC Juliet Law
Commission STATE OF OFission No. GC 4 6` NOTA42Y PU911
733 o STATE OF FLC( A
Expires 111, 312020
Re risad 07/I5/20I4 E,*ms 1111312 0
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DAl 1:
RECEIVED
DATE
COMPLETED
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