HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO!MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date;sa 1z _/V�T
RECEIVED
Building Permit Application
Planning and Development.5ervices APR 16 2018
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 P
Phone:(772)462-1553 Fax:(772)462-1578 Commercial ResiietFittiqg Departme t
F
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID#: 3414-501-1701-000/9 I-Pt 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:
-Addiftio-ri a I wo rk tobe Deffo-_rrned -und-ertftis-permit-check all that apply:
1jHVAC 13 Gas Tank E]Gas Piping n Shutters F]Windows/Doors
Electric QPlumbing OSprinklers Generator 01 Roof
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction.$ utilities:OSewer F-1 Septic Building Height:
-OWNER/LESSEE: CONTRACTOR: "
Name Wynne Building Corp. Name: James W Law
Address: 8()00 S US#I Suite 02 Company: Laws 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:_3052 — Fax: 772-878-3347
E-Mail: Phone No.- 772-971-4512
Fill in fee simple"ritle Holder on next page J if different E-Mail: lawselectricinc@aoi.com
from the Owner listed above) State or County Licensi.. 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:
DESIGNERfENGINEER: _z90tApplicable MORTGAGE COMPANY: ____Not Applicable
Name: Name: ti
Address: Address:
City: —State: City: State:
Zip: Phone- zip: Phone:
FEE SIMPLE 111L HOLDER: Z Not Applicable BONDING COMPANY: Not Applicable
Name: ]Name:
Address: Address-
ctv:
71p: Phone: Zip: Phone:
OWNER)CONTRACTOR AFFIDVIT:.Application is hereby made to 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 permit
St.Lucie Coun�y makes no representation that is granting a permit will authorizethe permit holder to build the subject structure
which is in con ict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult vurth your Home Owners Association and review your deed for any restrictions which may apply-
In consideration ofthe granting oftws requested permit,I do hereby agree that I will,in all respects,perform the work
in acconlanse 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 strurWres,swimming pools,fences,wall,signs,screen morns and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your payingtvAce for
improvements to your property_A Nonce of Commencement must be recorded and posted on the jobsite
before the fist inspection.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/AgeiiV Lessee ature of Contractor/license Holder
STATE OF FLORIDA S, LUCIE STATE OF FLORIDA
COUNTY OF COUNTY OF SM WICIE
The fo oinginssru
Ten t as acknowledgedhefore me The forgoing instrument was acknowledged before me
th�day of 20�;by this., clay o 26, I
JAMES W LAW .LAMES W LAW
(Mame of person adt =Oadging) (Name of person a'AmOledging)
(Signatu -Notary Public-State of Florida) (Signature Notary Rubric State of Florida I
Personally Known ' OR Produced Identification Personally Known '+✓ 'OR Produced Identification
Type of Identification Produced Type of Identification Proderued
Commission No. JWiet Law Commission ivo.lr G/�r%(o 7A (Seal)
NOTARY PU Jo et Law
NO
F FLORI!?A o E PUBLIC
Rased 07/15/201.4 tie � I 8:M- STATE OF
,; C TATE OF FI.oRIAA
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MAIN/2G�po
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COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE .
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CEIVED
MPLETED
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