HomeMy WebLinkAboutBuilding Permit Application a ALLRPPLICABLE INFO WILIST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: &�z Permit Numbed
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Building Permit
Application' NOV 2 0 2011
Planning and Development Services
y EUildi,79 and Code Reguiatlon Division I
2300 Virginia Avenue,Fort Pierce FL 34982 BY........................
Phone:(772)462-1555 Fax:(772)462-1578 Commercial Residential X
PERMITA.P'PLICATiON 'POR: Eiectrical nn
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PRI-POSED lNPROVEMENT LOCATION:
t Address:
i Legal Cyescription: -
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Property Tax iD#: 3414-501-1701-000/9 Lot No.
Site Pian Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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{ [3ETAlLEd DESCRIP OF WORK:
y Replace meter center with a combo pack
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CCI �TRUCT.CIN INFORMATION:
Additicnidworktorbenertiormed under this permit--check a t apply:
C y' Deas Piping nGenerator
Shutters FlWindows/Doors
HVAC vas Tank!^i Electric Plumbing �5prinkters Roof
Total Sc{_ Ft of Construction: S _Ft.of First Floor-
Cost c-, Construcdon:$�, / Q Utilities:Sewer l�nlSeptic Building Height:
' OWNER/LESSEE: CONTRACTOR:
i Name Wynne Building Corp. Name: .lames W Law
Address: 8000 S US#1 Suite 402 Company: Law's Electric, inc.
City. Port St.Lucie State: FL Address: 218 Beach Avenue
City:Zip Code: 34952 Fax: Ci Port SL Lucie State-. FL
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Phone No. 772-878-5513 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No. 772-971-4512
:ill in fee simple"Title Hoider on ne;d page o rf different: E-Mail: lawselectricinc@aol.corr.
'ram tle Owner listed above) State or County License: ER00011122
If value a:i construction is�?5tl0 or more,a RECORDED Notice of Commencement:is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNER/ENGINEER: 1!Not Applicable MORTGAGE COMPANY: �NOt Applicable
N2Me: ame:
Address: Address:
City-. State: City- State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: v,.Not Applicable
Name: Nance:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby madeto obtain a permitto do theworkand installation as indicated.
I certify that no work or installation has commenced priorto the issuance of a permit
St Lucie County makes no representation that is granting a permit will authorize the permit holderto build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibitsuch
structure.Please consultwith 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 agreethat l 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 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 tender or an attorney before
commencing work or recording our Notice of Commencement.
Sign re of Owner/Agent/Lessee Sig re of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA "`' -
COUNTY OF ' COUNTY OF 7 4 v (6,!ax'i
Theforeoinginst n�.wasp�l:rn�w,ledggd before me Theforeoing Inst meptvvpsacknowledged before me
thiP_.day of
20/. by thi:, L�siay of. � �p1A 20by
{Name of person acknowledging) (Name of person acknowledging)
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(Si natur of Notary Public-State of Florida) (5i atu� of Notary Public-State of Florida)
Personally Known i-" OR Produced Identification Personally Known i/ OR Produced Identification
Type of Identification Produced_ AllkType of Identification Produced
P iC */*CE
Juliet Lew
TATE O� OVNIssion No. GG d �i" NOTARY PUBLI7315
STATE OF FLCt A
Expires 11 312020 84673Explres'IN13121 120
Revised 07/1512014 '
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTL.E MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DAT-
COMPLETED
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