HomeMy WebLinkAboutBuilding Permit Application ALL APPLLCABLE_INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date:.' /(o 'r_-� / Permit Number:
f 1 -0310
Building Permit Application
Planning and Development Services
Building and Code Regulation Division ?
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
`PROPOSED (NPROVEMENT LOCATION:-
Address:
OCATION:Address: {
Legal Description:
Property Tax ID#: 1301-111-0001-000/5 ?(? Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Sidi:
DETAILED DESCRIPTION:OF WORK„
Replace meter center with a combo pack
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'CONSTRUCTION INFORMATION;
Additional work to be nertormed under this permit—check all th&U appy:
HVAC Gas Tank F_]-Tank Piping _Shutters Windows/Doors
aElectric ❑Plumbing Sprinklers E]Generator Roof
Total Sq. Ft of Construction: 5Ft.of First Floor-
Cost of Construction:$_4 �0. 0--) Utilities: Sewer Septic Building Height:
OWN:ER/LESSEE: CONTRA_ CTOR�'
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US#1 Suite 402 Company: Law's,lElectric, 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. 772-971-4512
Fill in fee simple Title Holder on next page(if different E-Mail: lawselectricinc@ao"I.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.'
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: j
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: tfNot Applicable
Address: Address:
city: State: City: I State:
Zip:_ Phone: Zip: Phone:
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FEE SIMPLE TITLE HOLDER: I//Not Applicable BONDING COMPANY: y N' of Applicable
Name: Name.-
Address:
ame:Address: Address:
City: City_
Phone: Zip_ hone:
OWPIER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permitto do the workand installation as indicated_
I cert-fy 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 ermit holderto build the subject structure
which is in conflict with anv oolica a Ho a Own rs Ass Cation ules.bvlaws r a gcovenanfs#hat rriav restrirt nr nr hihit ssirh
structure.Please consult wit�i your ome�wners Association ana review your deec�r r any restrictions;which may apply.
In consideration of the granting of this requested permit,l 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
comsmencin work or recording our Notice of Commencement.
Signa re of Owner/Agent/Lessee Si re of Contractor/License Holder
STATE OF FLORIDA - STATE OF FLORIDA 1 .
COUNTY OFCOUNTY OF
The fnreoing instruRwt wasacknowledggd before me The forgoing in I t was acknowledged before me
this;:j�;day of f 20/ by thi�.L'llay of 2t _by
(Name of person acknowledging) (Name of person acknowledging)
(Si atu of Notary Public-State of Florida j (Sihm-affiuh of Notaiy Public--State of Florida)
Personally Known ✓OR Produced Identification Personally Known OR Produced Identification'
Type of Identification Produced Jolfet-t Type of Identification Produced
Commission No. �� : _ STATE OF O! ission No_ 6 C 041(�"" ° NOTARYpUBU
CQdwX i ccw STATE OF FLq A
Expires 11) 3/2020 r
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Expires 11!13[2 0
Revised 07/15/2014 -
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION' SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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