HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAB-E INFO MUST 3E COMPLETED FOR APPLICATION TO BE ACCEPTED
RECEIVED
Date- ___( _ Permit Numb
1106- ao6p
w 3, JUN 0 4 2018
Puiiding Permit Application
Planning andPevelopmentSenvices Permitting Department
8uilcing7ndCode Regulation Division St. Lucie County, FL
230CI Virginia Avenue,Fort Pier.:e FL 34982
Phone_(772)462-1553 Fax. (772)462-1578 Commercial Residential X
PERMIT AP;) ICATION FOR: Electrical
PROPOSED IiNPROVEMENT LOCATION:-
Address:
OCATION:Address:
Legal DEscripti Dn:
i, Propertv Tax ID t#: 1341-111-0001-000/5 ? c' Lot No.
Site Plan Name: Block No.
Proje:t:Name:
Setbad:s Fromt Back: Right Side: Left Side:
DETAILED CtE5CR1PTI6N OF WORK:
L
Replace rieter center with a combo pack
CONSTRUCTION INF-CIRMATION:
Additional wor to ee ertormed under tis permit—check all app V:
E1HVAC U Gas Tank ❑Gas Piping _Shutters a VYindows/Doors
LIE;ectric F71 Plumbing Sprinklers Generator a Roof
Tota' Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Zorstr,_ction:$ J �� JU Utilities:ESewer F I Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Narre 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 :ode: 34952 Fax: City: Port St_Lucie State: FL
Phone No. 772-878-5513 Zip Code: 34952 Fax: 772-878-3347
E-Nail: Phone No. 772-971-4512
Fill in fee simple Title Holder on ne>:t page(if different E-Mail: lawselectricinc@aol.com
from the Owner listed above) State or County License: ER0000122 f
If value of cons'suction is 52500 or more,a RECORDED Notice of Commencement is required.
I
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SUPPLEMENTAL CONSTRUCTION LIEN LAW 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: _j/ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Courcy 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 Assoraation 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 recorddin� our Notice of Commencement.
-§0IQ6u re of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINT LUCIE COUNTY OF SAINT LUCIE
The forpoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisay of Z—"1. - 20.(.Zby thisIay of 20,!g by
NAMES W LAW JAMES W LAW
(Nrlof person acknowledging) (Name f erson acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known ''—� OR Produced Identification Personally Knowny OR Produced Identfiication
Type of Identification Produced Type of Identification Produced
Commission No. Commission No._.�`9�� (Seal)
`"-"• ANNE
BROWN W LMACH ANNE BROWN WALMACH
ION#FF984663 MY COMMISSION ti FF984663
Revised 07/15/2014 icor EXPIRES April 21,2020 :'+o. EXPIRESAxiP21,2020
f Nots NAM 1(407)398.0153
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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