HomeMy WebLinkAboutBuilding Permit Application 1
' ALLAPPLICAALE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �
Date; ? Permit Number:_ 1 wa
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Building Permit Application ;. aEC0 !
Planning and Devetopment5ervices 217
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Building and Code Regulation Division
i PEA'MITTING
2300>rrginia avenue,Fort Pierce FL 34982 ##. i,
Phone:(772)462-1553 Fax:(772)462-1,.578 Commercial ReSiCItr11�I2Tucie L)Qunty, FL
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PERMIT APPLICATION FOR: Electrical E
PROPOSED INPROVEMENT LOCATION:
Address �f'
Legal Description: I
Property Tax ID##: 130k111-0001-00016 Lot No_
Site Plan Name: I Brock No.
Project Nam:
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION OF WORK: t'
Replace meter center with a combo pack: �
CONSTRICTION INFORMATION:
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q itiona war to e e Orme under ttspermtt—c ec a appy:
HVAC F]GasTank ❑Gas Piping _Shutters W ndows/Doors
Electric ElPlumbing ElSprinkiersI wJ Generator LJ Roof
Total Sq_Ft,of Construction: Sq.Ft.of First Floorl
Cost of Construction:$ QO r o'n _ utilities: ,_Sewer El Septic i'`' Building Height: .s
OWNERAESSEE: J CONTRf-:CTOR::
Name 1Nynne Building Corp. Name: James;w Law;:
Address: 8040 S US#1 Suite 402 Company: Law's Electric„inc-
City: Port St_Lucie State: FL Address: 218 Beach Avenue
34,952 Fort St.L.uciel'i
Zip Cade- Fax: City: � State: PL
Phone No. 772-878-5513 Zia Code: 34952' Fax: 772-878-3347
E-Mail: Phone No. 772-971-4512
Fill in fee simple T;tle Holder on next page(if different E-Mail: lawselectricir%c@aai-Com
from the Cwner listed above) State or County License: i ER0000122
if value of construction is$2540 or more,a RECORDED Notice of Commencement is required_ ;
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SUPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: ;, t�Not Applicable
1�4am`e: Mime: i
Address: Address: '
City: State: City: I State:
zip: Phone: Zip: Phone: i i
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FEE SIMPLE TITLE HOLDER: i/Not Applicable BONDING COMPANY: 'v- Not Applicable
Name: Name: I'
Address: Address: I II
City: City:
Zip: Phone: Tip: Phone:
OWAIER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permitto do the work and installation as indicated.
I ceitifilthat no work or installation has commenced priortothe issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize theermit holde'to buil 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 dead for any restrictions which may apply_
in consideration of the granting of this requested permit,I do hereby agreethat I will,in all respect's,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 afull concurrency1review:i room a'dditio'ns;
:accessory structures,swimming pools,-Fences,wails,signs,screen rooms and accessory uses to another non-residential use
1WARNING TO OVIMER: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
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commencirig work or recordin • our Notice of Commencement. I i
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L;Z�W, z ar A� `
Signs re of owner/Agent/Lessee Sig ure of Contractor/License Holder
STATE OF FLORIDA - + STATE OF FLORIDA I''
COUNTY OF COUNTY OEc ,lre'i
The fnre ing ins[ruo[�entWas pGknpwledged before me The forgoing inst[umeptw s acknowledged before me
thi ria of J 20/-z y thi5r ay of_. � 20 by
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(Name of person acknowledging) (Name of person acknowledging)
(S atur of Notary Public-State of Florida) (5i atu of Natary li ublic-State oflFlorida)
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Personally Known ----,OR Produced Identification. Personally Known i-- OR Produced Identification
Type of Identification Produced � hype of IdentificationWoduced
-iCC i', •• Juliet Lau
Commission No. G'� �. ' •I STATEOF Omission No_ GG "� NOTARYPUBLl
135
Expires 11! 312020 ° STATE OF FLQ A
Revised 07/15/2014 f 9 F 11l13L2 0
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION; SEA TURTLE. MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW i, REVIEW REVIEW
DATE I' i
RECEIVED
DATC
COMPLETED
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