HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:���CJ, / ?/� Permit Number:. �IS a
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Building Permit Applilcati
RECEIVE®
Planning and ElevelopmertServices
Building and Code Regulation Division NOV 13 2017
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(7721)462-1553 Fax: (772)462-1578 Commercial PlOviliftbW Debartment
St
OL. Lude CountyFL
PERMITAP?LICATION FOR: Electrical '
PROPOSED INPROVEIVIENT LOCATION:-
Address: CPQ v
Legal Description:
PropertyTax ID#: 13D1-111-0001-00015 ? (_ Lot No_
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center%ith a combo pack at each address
CONSTRUCTION INFORMATION:
Additional work to be pertormed under tis permit—check all that appy:
QHVAC 1_I Gas Tank DGas Piping a_Shutters Windows/Doors
Electric Pl imbing Sprinklers n Generator Roof
Total Sq.Ft of Construction: 5 Ft.of First Floor:
Cost of Construction:$ Utilities"n Sewer a Septic Building Height:
I OIAINER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US#1 Suite 402 Company: Law's Electric.Inc_
Cit,_ Port St_Lucie State: FL Address: 298 Beach Avenue
Zip Code: 34952 Fax: City: Port St. Lucie State: FL
Phone No. 7'872-87B-5513 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: lawselectricinc(p_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:
DESIGNER/ENGINEER: -,/Not Applicable MORTGAGE COMPANY: v. Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _IL_Not Applicable BONDING COMPANY: _, Ncit Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFI1DVIT:Application is hereby made to obtain a permitto 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 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_
Thefollowing 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 twice for
improvements to your property.A Notice ofCommencement 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 your Notice of Commencement.
Sign`fture of owner/Age t/Lessee 51)4tore of Contractor/License Holder
STATE*OFFLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing lnstrm ent was acknowledged before me
this./-5-�yof '22�- 20 -L7
_ZJ by this. d a 20 —by
(Name acknowledging) (Name of person acknowledging)
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(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida
Personally Known_OR Produced Identification Personally Known_OR Produced Identification
Type of Identification Produced Type of Identification Produced
NNE BRO
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466,
�qaqROWN WALMACH
Commission Na. WN WA ssion Na. M COMMISSION ff FF9,84663
Y COMMISSION#FJ 9W84663
EXPIRES April 21 'n*A EXPIRES April 21,2020
(407)398-0153 FkXWaN0hrfServma,c"
Revised 0711512014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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