HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MIST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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RECO VED
Building Permit Application
MAR 3 d A18
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce F134982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical Q
PROPOSED INPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax I D#: 3414-503-1701-000/9 6eJ 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:
Additional work to e e orme under is permit—check a appy:
11HVAC be performed
Gas Piping _Shutters t___1 Windows/Doors
RJElectric Q Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: So.Ft.of First Floor:
Cost of Construction:S vrG�'i Utilities:R Sewer 1:1Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name- .lames W Law
Address: 8000 S US#1 Suite 402 Company: Laws Electric, Inc.
Cm,: 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: ER000012-2
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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ill SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ^Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zp: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: ^Not Applicable
Name: Name:
Address: Address:
I Ci._ City:
zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFEIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated_
1 certify that no work or installation has commenced prior to the issuance of a permit-
,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 usesto 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
commencing viork or recording our Notice of Commencement-
I
ature of Owner/Agent/Lessee ature of Contractorjlicense Holder
4 STATE OF FLORIDASTATE OF ORIDA
S-1 LUCiE COUNTY OFST- LUCIE
COUNTY OF
Thefo Ding instrument'was acknowledged before me The forgoing instrument was acknowledged before me
j this�day 2o1 _bY this a day of ,20, by
JAMES W LAW
JAMES W LAW
(Name of person adicmm!dledging) (Name of person a'ckff0*ledging)
(Sigtra . of Notary Public-State of Florida)
( gnature f Notary Public-State of Florida)
Personally Known %Z OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced _ Type of Identification Prodeiued
commission No_ G G U`fj(- Ju" Law Commission Ivo_ (5eal)
NOTARY PURL JuFel lay
C> STATE
s, ,e Conn*GG046735 STATE OF FLOR1pA
Revised 07/15/2014 Expires 1 1A312020 , a Cann#GG048735
D20
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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