HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Permit NumbEr-. o
RECEIVED
Building Permit Applicatio JqN 2 9 2018
Plonning and Development Services
Building and Code Regulation Division P�rmltting
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie County,
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical o
PROPOSED INPROVEMENT LOCATION:
Address: _ /3
Legal Description:
Property Tax ID#: 130,-111-0001-000ie
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:
ACIC11tional work to be performed under this permit—check all tbat appy:
HVAC Gas Tanlc []Gas Piping _Shutters Q Windows/Doors
DElectric L�i Plumbing O Sprinklers E Generator ❑Roof
Total Sq. Ft of Construction: Sq. Ft_of First Floor:
I Cost of Construction:$_c�7. O )- Utilities:Sewer F1 Septic Building Height:
OWNER/LESSEE: CONTIV5.CTOR:
( Name Wynne Building Corp. Name: James W Law
E+ 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 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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERIENGINEER: ✓ Not Applicable MORTGAGE COMPANY: ✓ Not Applicable
Name: Name:
Address: Address:
City: State: Clty: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: blame:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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
commencingcommenclng work or recording our Notice of Commencement-
Si
ommencementSi tyre of owner/Agent/Lessee Anature of contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINT LUCIE COUNTY OF SAINT LUCIE
The fnrening in Pmt was acknowledged before me The forgoing instniment_w_as acifnowledged before me
thisc! ay of20 thi&A_?�ay of 20„ by
.DAMES W LAW JAMES W LAW
{ e of person acknowledging) (N of person acknowledging)
(Signature of notary Public-State of Florida) ( ignature of Notary Public-State of Florida)
Personally Known ✓ OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. 6C&2�la 63 Commission No. (Seal)
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DATE
COMPLETE
INITIALS
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