HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MOST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: /Y 0
Building Permit Application MAR 12. 2018
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
I PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address: l
Legal Description:
Property Tax ID#: 130.6-11 1-0001-0001d Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
I
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
- i
CONSTRUCTION INFORMATION:
Additional work to beve orme unclerthis permit—check all tbat appy:
HVAC U Gas Tank E]Gas Piping _Shutters Windows/Doors E.
P
Electric ❑ Plumbing ❑Sprinklers E Generator F� Roof
Total Sq- Ft of Construction: / Sq. Ft.of First Floor-
Cost
loor
Cost of Construction:$_/d esd.�� Utilities:0 Sewer 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 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:
DESIGit1ERJENGtNEER: _ Not Applicable MORTGAGE COMPANY: _Nat Applicable
Name: Name:
Address: Address-
Oty: State: city. State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDtit: Not Applicable BONDING COMPANY: ZAot Applicable
Name: Name:
Address: Address:
City: City:
ZIP-- Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:.Application is hereby madeto 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 Count�yy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con ictwith any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Assocratibn and review your deed for any restrictions which may apply.
in consideration ofthe granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance% ith 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 irrtend to obtain financing,consent with lender or an attorney before
commencing work or recording our Notice of Commencement.
Wfiature of Owner)Agent/Lessee ature of Contractorlucense Holder
STATE OF FLORIDA .LUCIE STATE OF FLORIDA
COUNTY OF COUNTY OF ST. WCIE
The forgoing instrument was acknowiedggd_before me Theforgoing instrprnentwas acknowledged before me
this__A_day of .20 by this/.j day of J 2[) by
.LAMES W LAW JAMES W LAW
(Name of persona&mmlledging)' (Name of person a'hftno*ledging)
{Sig of otary Public State of Florida) (Sgnatur-e f Notary Public State of Florida)
Personally Known •✓ OR Produced id_entification Personally Known '✓ 'OR Produced Identification
Type of Identification Produced Type of Identification Prodeiaed
Commission No. GG04k,7_7�L,`` Juliet Law Commission Ivo._ ,-G,D<<�9 3S' (Seal)
NOTARY pugLj C Juliet Law
MA STATE OF ED OR 1QA
Comm#GGM?35
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Revised 07115/2014 Expires 1119312020 STATE OF FLORIpA%WCWM;#GG046735
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
[[RECEIVED
DATE
COMPLETED
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