HomeMy WebLinkAboutBuilding Permit Application i
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l
Date: 2� �U� ��'7 Permit Number: i
REECEIVE
_7 Building Permit Application 2017
Planning and Development Services PE W 1171 NG
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772) 462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical -i
PROPOSED INPROVEMENT LOCATION:
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Address: 1
Legal Description:
Property Tax ID#: 3427-111-OOD2-00015 I Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack
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CONSTRUCTION INFORMATION:
Additionai work to be ertormed under tis permit—c ec al I that appy: 'I I
HVAC Gas Tank ❑Gas Piping Shutters Q Windows/Doors
1J Electric ❑Plumbing Sprinklers Generator Roof
Total Sq_Ft of Construction: Sq.Ft_of First Floor:
Cost of Construction:$ 0,ef)a Utilities:USewer 0Septic '! Building Height-
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law{
Address: 800D S US#1 Suite 402 Company: Law's Electric! Inc. j
City: Port St.Luc-re State: FL Address: 216 Beach Avenue
Zip Code: 34952 Fax: City: Port St. Lucie; State: FL
Phone No. 772-678-5513 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No_
772-971-451:2
Fill in fee simple Title Holder on next page I if different E-Mail: lawselectricic@aol.com
from the Ownek listed above) State or County License: ' ER0000122
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.`I
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERIENGINEER: —!!:�N—ot Applicable MORTGAGE COMPANY: 1 v- Not Applicable]i
MaPMe:
Address: Address:
City: State: City: i State:
Zip: Phone: Zip: Phone: I
FEE SIMPLE TITLE HOLDER: L/Not Applicable' BONDING COMPANY: Not Applicable
Narnez
Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
1 certify that no work or installation has commenced prior to the Issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize thepermit holder', build the subject structure
which is in conflict with any applicable Homeowners Association rules,bylaws or-an Cal c enantshayre " orprohibitsuch
structure.Please consult with your Home Owners Association and review your deed for any .r ns which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,pe a work
in accordance iWith the approved plans,the Florida Building Codes and St Lucie County Amendme J1 .
The following building permit-applications are exempt from undergoing-a full concurrency review:Loom a additions,,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses )D a I t er non-residential use
WARNING TO OWNER:Your fallureto Record a Notice of Commencement may result in your paying twice for ,
improvements to your property.A Notice of Commencement must be recorded 4hd posted on the jobsite
before the first inspection.If you intend to obtain financing,consult with lender o'I an attorney before
commencing work or recordina your Notice of Commencement
Sign re of Owner/Agent/Lessee Sig re of Contra cto r/Licens 1�6 Holder
STATE OF FLORIDA STATE Of FLORIDA
COUNTY OF COUNTY OF
The forgoing instrujAentWps pgknpwIedg2d before me The forgoing -9tw before me
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(Name of person acknowledging) (Name of person acknowledging
(Stin-a-t-uW of Notary Public-Siate of Florida
(Slja5tt f Notary Public-State of Florida)
Personally Known 4- �OR Produced Identilication..,,.-t. Personally Known i-- OR Produced Identification
Type of Identification Prod uced._ J&.X&o Type of Identification Produce'd
ft: JARY tag� Juliet Law
Commission No. 6E IP4L Z. <— -'STATE OF F LON%ission No. NOTARY PURL]
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Expires 11113/2020
Expires 11113121 20
Revised 07/IS12014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION , SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
BATE 1
COMPLETED
t,,d -8526-699-699
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