HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7 ��" % ,. rT Permit Number: 11 11 63 O1
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Building Permit APRlic t
CEIVED
Planning and Development Services NOV 13 2017
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Permft iDepal-tment
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEIWIENT LOCATION:-
Address:
OCATION:Address: �L- l Q�
Legal Description:
Property Tax ID#: 1301-111-0001-00015 % (_ Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
CONSTRUCTION INFORMATION:
Additional work toe e orme under tis permit—c ec a appy:
HVAC Ei Gas Tank E:]GasPiping _Shutters 0 Windows/Doors
Electric 0 Plumbing Sprinklers 1:1Generator 0 Roof
Total Sq.Ft of Construction: SFt. of First Floor:
Cost of Construction:$ /� G d . d Utilities:In Sewer 0 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. name: James W Law
Address: 8000 5 US#'I 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. 772-878-5513 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No. 772-9714512
Fill in fee simple Title Halder on next page(if different E-Mail: lawselectricinc@aol.com
from the Owner listen 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 LAIN INFORMATION:
DESIGNERJENGINEER: �Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _1/Not Applicable'- BONDING COMPANY: ✓Not Applicable
Name: " Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER]CONTRACTOR AFFIDVIT:Application is hereby made to obtain a perrnitto 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 Countyy 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 Associatibn 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 exemptfrom 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 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 our Notice of Commencement.
� ,waew-��
Sign re of Owner/Agent/Lessee Sign re of Contractor/License Holder
STATE OF FLOiiIDAi STATE OF FLORIDA
COUNTY OF eGf��,� COUNTY OF
The fon?oing instrument was acknowledged before me The forecing instr Ment was acknowledged before me
thi!.� day of -r�- 20% by thi day
(Name of person acknowledging) (Name of person acknowledging)
{Si atur of Notary Public-State of Florida) (Skna-t-uh of Notary Public-State of Florida)
Personally Known ✓OR Produced Identification Personally Known i�— OR Produced Identification
Type of Identification Produced AlbUAt. Type of Identification Produced
Y.IN 1ICJuliet Law
Commission No. G'O ��� °` �STATEOF ftftslon No_ �G D NOTARY PUBLIC
G 048735 STATE OF FLRR A
Exo1res 1 /1312020
~ .s Eyires 11!13,;2 0
Revised 07/15/2014 -
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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