HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED���
Gate �(,,,z_ �0 Permit Number:
I
Building Permit Application APR 10 2018
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST, Lucie County, Permitting
Phone:(772)462-1553 Fax: (777-)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical 0
PROPOSED INPROVEMENT LOCATION:
Address: /o
LegaS Description:
Property Tax ID#: 130111-0001-0001- 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:
ACSC11110nal woric to De erformed under this permit–check all that apply:
QHVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
aElectric Plumbing Sprinklers FIGenerator O—Roof
Total Scl.Ft of Construction: S�Ft.of First Floor:
I Cost of Construction:$ c��. Of) Utilities: L`I Sewer F1 Septic Building Height:
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OWNER/LESSEE: CONTV-%iCTOR:
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: 772-87B-3347
E-Mail: Phone No. 772-971-4512
Fill in fee simple Title Holder on next page(if different E-Mail: lawselectricinc@aoLcom
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 LAIN INFORMATION:
DESIGNERJENGINEER: / Not Applicable MORTGAGE COMPANY: ✓ Not Applicable
I Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: /Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone: r
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 Nome Owners Association and review your deed for any restrictions which may apply-
in
pplyin consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
4 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
commencing work or recording our Notice of Commencement.
Sig re of Owner/AgentJ Lessee S'Ignature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY-OF SAINT LUCIE COUNTY OF SAINT LUCIE
The forgoing instrument was acl owledged before me The fo Qoing instrurtlen was acknowledged before me
thist:-cam ay of 20 (�by this�,,Zlay of 20�by
TAMES W LAW JAMES W LAW
(N a of person acknowledging) i (Name f therson-acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known t-- OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. 9 -_�G Commission No. _/�9�I7 (Seal)
ANNE BROWN W LMACH
"' ANNE BROW!WALMACFi
- SSION#FF984663 MY COfiIMlSSION#FF984S63
Revised 07/1512014 (norj mss ExP N A 121.2020 ''?a EXPfRESApriI21.2020
,ppb I!407/348-0153
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIMI REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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