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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO SE ACCEPTED Date: Permit Number: Building Permit Application Planning and Development Services LIAR 12 2018 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772)4621-1578 Commercial Residential X PERMIT APPLICATION FOR: Electrical PROPOSE© MPROVEMENT LOCATION: Address: Legal Description: Property Tax ID#: 130,4',111-0001-000i-0 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 at each address CONSTRUCTION INFORMATION: Additional work to (e e orme rs uer t rs permit—check all I appy: HVAC L=1 Gas Tank Deus Piping Shutters a Windows/Doors h Electric ❑ Plumbing Sprinklers a Generator El Roof �I Total Sq.Ft of Construction: r SrlFt.of First Floor. Cost of Construction:$ (::p CD Utilities. Sewer ESeptic 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-Z513 Trp Code: 34952 Fax: 772-878-3347 E-Mail: Phone No. 772-971-4512 Fill in fee simple Title Rolder on next page(if different E-Mail: lawselectr'scincaeol.com from the Owner listed above) State or County License: ERD000122 ltvaltie of construction is$250D or more,a RECORDED Notice of Commencement is required. 9'd -99ZI•-699-699 L-1�099L9ZLLMV1 eZ6:60 96 Z1, aelN SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _zNot Applicable MORTGAGE COMPANY: Not Applicable Fume: Name: Address: Address: CW. State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDiER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: city: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a penmmitto Bothe work and installation as indicated. I certifythat no work or installation has commenced prior to the issuance of a permit. St.LudeCoun makes norepresentationthat isgrantingapermitwWauthonzethe ermitholdertobuild thesubjectsGvcture which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such structure.Please consult vwth your Home owners Assodatibn and review your deed far 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 Lude County Amendments. The following building permit applications are exempt#rom undergoinga full concunencyreviW-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 inspectiom if you intend to obtain financing,consult with lender or an attorney before commencing work or recording our Notice of Commencement S' ature of Owner/AgeW Lessee 5149hature of Contractor/License Holder STATE OF FLORIDAS 1- LUCIE STATE OF FLORIDA COUNTY OF COUNTY OF ST. LUCIE The forgoing instrument was acknowledged before me Theforgoing instrumentwas acknowledged before me this.-Zaday of j2!&/r.) .21? .2- by this qday of 213, ;by JAMES W LAVA JAMES W LAW (Name of person aftc zu adging j (Name of person atknwMedging) L I-Q; (Signatu Notary Public-State of Florida) (Signature Notary Public-State of Florida) Personally Known '•✓ OR Produced Identification Personally Known '✓ 'OR Produced Identification Type of Identification Produced - Type of Identification Produmd Commission No-4 GlIb4b� I .mullet Law Commission No. Jnr 73S' (Seal) Noi'ARY PUBUV filet Law OfAl-EOF FLORi4A YPUBLIC Revised 07115/2014 a C=ftGG648?W- STATE a�FLoaiga Expires 11/1 Comrr�q OF . xp rea pp���� REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEATURTLE MAI1'I1/73//��GROVf COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED BATE COMPLETED V'd -89Z6-699-L99 ztos8L8ZLLmv13Z6:60 86 Z6 JaW