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HomeMy WebLinkAboutBuilding Permit Application i j ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q c� Date: ,-:TO n Permit Number ('�:, Q 0 ' �•.,1 I ' I t5rg a RECEIVED Building Permit Application JAN 09 2019 Planning and Development Services Building and Code Regulation Division Permitting Department 2300 Virginia Avenue,Fort Pierce FL 34982 ( Vit• 4ucie County Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X !PERMIT APPLICATION FOR: Electrical PROPOSED INPROVEMENT LOCATION: ;Address: /` 4,52"T 7 dd,/,4_Le4z -,�) Legal Description: Property Tax 1D#: 130A6-111-0001-0=49 Lot No. Site Plan Name: ' I Block No. Project Name: Setbacks Front Back: Right Side: Left Side: ? '' DETAILED DESCRIPTION OF WORK: Replace meter center with a combo pack: CONSTRUCTION INFORMATION: AdditionalWOrKTObe performedunder this permit—check a appy: ! ❑ ( HVAC U Gas Tank ❑Gas Piping _Shutters Windows/Doors i n Electric 0 Plumbing Sprinklers Generator i, L__.4 Roof Total Sq.Ft of Construction: Sq.Ft.of First Floor: ' Cost of Construction:$ oD r 00 Utilities: ^Sewer©Septic Building Height: OWNER/LESSEE: CONTRACTOR: i Name Wynne Building Corp_ Name: James W,Law Address: 8000 S US#1 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 i Fax: 772-878-3347 E-Mail: Phone No. 772-9714512 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 i i if value of construction is$2500 or more,a RECORDED Notice of Commencement rs required. j SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION: . i DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY ✓Not-Applicable Name: Name: Address: Address: City: State: City: I State: Zip: Phone: Zip: Phone: I I FEE SIMPLE TITLE HOLDER: I✓Not Applicable BONDING COMPANY: ' c/Not Applicable Name: Name: Address: Address: city: City: I Zip: Phone: Zip: Phone:I � I 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 sLIL-ucie Count, 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 covenantsthat may restrict or prohibit such structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply. Iti 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 1pnd posted on the jobsite Before the first inspection. If you intend to obtain financing,consult with lenderl or an attorney before do'mmencin work or recording our Notice of Commencement. Sin re of Owner/Agent/Lessee Sig ure of Contractor/Lice i se Holder STATE OF FLORIDA Q �/ STATE OF FLORIDA COUNTY OF _11�` .Gl�.� COUNTY O The forgoing instrumeniwas a�kn_owledged.before me Theforaoing instnI entwas acknowledged before me ay of 201y thin. _--'slay o O oby i (Name of person acknowledging) (Name of person acknowledging) I i( i atur of Notary Public-State of Florida) (Si atu of Notaiy Public-IState of Florida) ✓OR Produced Identification Personal) Known '✓ OR Produced Identification Personally Known y Type of Identification Produced T C of Identification Produced _ Juriet Law Commission No. C=0 : - W� _STmTE GFFQ673�RAssion No_ 6G d NOTARYPUBL! C-09s Expires 11/1-3/2020 I STATE OF FLCt A : Revised 07/15/2014 Expires 1111312 0 i ,REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED I I I