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HomeMy WebLinkAboutBuilding Permit Application ALL APPLIC LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building Permit Application ;" Tg(�" ` Planning and Development Services Building and Code Regulation Division 0 F C -9 R 2017 2300 Virginia Avenue, Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772)462-1578 Commercial Re ential X PERMIT APPLICATION FOR: Electrical PROPOSED IMPROVEMENT LOCATION: Address: Legal Description: PropertyTax ID#: 130k111-0001-000b0 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 CONSTRUCTION INFORMATION: Additional worK to e erformed under this permit–check all appy: ❑HVAC Gas Tank F]Gas Piping _Shutters Q Windows/Doors ZElectric Plumbing Sprinklers El Generator F] Roof Total Sq.Ft of Construction: S�Ftj of First Floor: Cost of Construction:$ ©D . D� Utilities- Sewer El Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Wynne Building Corp. Name: James W Law Address: 8000 S US#1 Suite 402 Company: Law's Electric, Inc. City: Port SL 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. 772-971-4512 Fill in fee simple Title Holder on next page(if different E-Mail: lawselectricinc@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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not 1pplicable Name: arae: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: r,/Not Applicable Name: 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. 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. 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 lender or an attorney before commencing work or recording our Notice of Commencement. Sign re of Owner/Agent/Lessee Sig ure of Contractor/License Holder STATE OF FLORIDA Q /j STATE OF FLORIDA COUNTY OF le-1 COUNTY OF The foraoing instrujaLentwas p( ed before me The foreoing inst fumept w,�s acknowledged before me thi day of �/l�p J 20%7by thisi.�slay of._ QV&� 20 by (Name of person acknowledging) (Name of person acknowledging) (Si atur of Notary Public-State of Florida) (Si atu of Notary Public-State of Florida} Personally Known ✓OR Produced Identification Personally Known ✓ OR Produced Identification Type of Identification Produced OTARY Type of Identification Produced -IC Juliet Law Commission No. G'� 7 STATE GG LO%M No. ��D NOTARY • Expires 11/ 312020 STATE OF FLR A Revised 07/15/2014 y 's'i'c, 9 Expires 11113121120 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED