HomeMy WebLinkAboutBuilding Permit Application ALL APPLICA -•E INFO MUST 3E COMPLETED FOR APPLICATION TO BE ACCEPTED
DatE: � _tea 7 Permit Number: d �o
Building PermitA�pi�catio RECEIVE®
Planning and C�evelopment5en+ices
Building-qnd Code Regulation Division
2300 Virginia Eiyenue,Fort PFer_e FL 34982 NOV 12017
Phone:(772}452-1553 Fax: (772)462-1578 Commercial Residential X
PERRAITAP?UCATION FOR: Electrical st, Lucie County, FP
PROPOSED INPROVEIV3ENT LOCATION:-
Address:
Legal Descripti)n: �.
Proper0f Tax ID#: 1301-111-0009-00015 ? Lot No.
Site Plan Mame: Block No.
Project:Jame:
Setbacks Fro-it Back: Right5ide: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack
CONSTRUCTION INFORMATION:
• Additional work to (e�e orme un ert ispermit—c ec a t appy:
HVAC LJ Gas Tank ❑Gas Piping Shutters a Vilindows/Doors
Y E ectrie El Plumbing Sprinklers Generator Raof
Tota:Sq_Ft of Construction: S Ft.of First Floor_
Cost of Constr-ction:$-,_ J ��° Je) Utilities: Sewer❑Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp_ Name: James W Law
Address: 8DC0 S US#1 Suite 402 Company: Law's Electric. Inc.
City: Port St. Lucie State: FL Address: 218 Beach Avenue
Zip --ode: 34952 Fax-. City: Port St_Lucie State: FL
Phone No_ 772-876-5513 Zip Code: 34952 Fax: 772-878-3347
E-Nail- Phone No. 772-971-4512
Fill in fee simple Title Holder on next page(if different E-Mail: lawselectricinc@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 required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERJENGINEER: _Not Applicable MORTGAGE COMPANY= ✓Not.1ppJicable
1Vame. ame:
Address: Address:
C'riy: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: I//riot Applicable .BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City_ 'City:
Zip: Phone: Ti p: Phone:
OWN ERJ CONTRACTOR AFFIDVIT:Appiication is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit
St_Lucie GountV makes no representation that is granting apermit 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,l 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 exempt from 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 paying twrice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobs'Ite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Sign re of Owner/Agentf Lessee Sig ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF v -11,e-I_Z,
The foreoing instrurnlen as Sknowledged before me The forgoing instrume t w s acknowledged before me
this (,day of _ ZO%. by thi� ,day pf, 20by
(Name of person acknowledging) (Name of person acknowledging)
(5i atur of Notary Public-State of Florida} (si atu of Notary Public-State of Florida}
Personally Known -'� OR Produced Identification Personally Known i--- OR Produced Identification
Type of Identification Produced T pe of Identification Produced
NOT/{AYP C Juliet Law
Commission No- =&� -°` •$TATE OF F LONDhission No. 6 016-7NOTARY PubIJ
Expires iG1 .3r 020 STATE OF FLR A
Revised 07/15f20I4 WNCES . Expires 1111312 0
REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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