HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED y
Date: lC>�� Permit Number
Building Permit Application RECEIVED
Planning and Development Services
Building and Code Regulation Division MAY 14 2018
2300 Virginia Avenue,Fort Pierce FL 34982 Permitting
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Re idle12tW count
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: l _�S
Legal Description:
Property Tax lD#: 3427-111-0002-00015 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:
Additronal work to be performed under tispermit—check al I that appy:
HVAC Cas Tank FGas Piping s L.__
_Shutter1 Windows/Doors
Electric 1:1 Plumbing ❑Sprinklers El Generator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$_ / y(�Y�, eo Utilities: Sewer Septic Building Height:
OW N ERAESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: .lames 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: 34352 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$25Do or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: ;/Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER Not Applicable BONDING COMPANY: v/Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: 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 a permit
St Lucie County makes no representation that is granting a permit will authorize thepermit 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 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 recordina your Notice of Commencement.
Signa re of Owner/Agent/Lessee Sign ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA L
COUNTY OF COUNTY OF
The fo��re,g9n�g instru nt was_agknowledged before me The foreoing instn-m-rix as ackpowledged before me
thisi-/ ay of,,,,�� - _20/ y tfii�:day o - Of Eby
(Name of person acknowledging) (Name of person acknowledging}
{S�grrtur of Notary Public-State of Florida) (Si�atu of Notary Public-State of Florida)
Personally Known --- OR Produced Identification Personally Knowny OR Produced Identification
Type of Identification Produced t T C of identification Produced
PART Juliet Law
STATE OF LO u ••
Commission No. Cs- �-� fission No. f
NOTARY
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Revised 07/15/2014
PNS FRONT ZONING SUPERVISOR PLAINS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
ED
DATE
COMPLETED
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