HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 0 7-
O 114
Date, Permit Num
RI-VEDECL_V EDRe§he"ie
iZE
Building Permit Applicatio
Planning and Development Services
Building and Code Regulation Division Department
2300 Virginia Avenue,Fort Pierce F!_34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial y, FL
PERMIT APPLICATION FOR: Electrical -�
PROPOSED iNPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID#: 3427-111-0002-000/5 '/ 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 at each address
CONSTRUCTION INFORMATION:
Atldmonal work toe e orme under tis permit—check a apply:
aHVAC El Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric El Plumbing Sprinklers 0 Generator EIRoof
Total Sq.Ft of Construction: S Ft.c f First Floor:
Cost of Construction:$ /- 00C),e �� Utilities:cnSewer F]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
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: Part St. Lucie State: FL
Phone No. 772-878-5513 Zip Code: X952 Fax.-
E-Mail:
ax:E-Mail: Phone No. 772-9714512
Fill in fee simple Idle 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$2300 or more,a RECORDED Notice of Commencement is required.
9'd %C:01 81 66 Irf
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION_
DESIGN ER/EN CINEER: il Not Applicable MORTGAGE COMPANY: -,Not Applicable
Name. Name:
Address: Address:
City: State: City: State:
Zip: 'hone: Zip: Phone:
FEE SIMPLE TITLE!-HOLDER: Not Applicable BONDING COMPANY: r%NotApplicable
Name: Name-
Address: Address:
City: City:
Phone: Zip: Phone:
OWNER]CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permitto 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 the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Asst,dation rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consultwith your Home Owners Association and review your deed for any restrictions which may apply.
16 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 exemptfrom undergoing a full concurrency review:room additions;
accessory structures,swimming pools,fences,wails,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
t ammencing work or recordingyour Notice of Commencement.
Sign re of Owner)Agent)Lessee sgn ure of Contractorl cense Holder
STATE OF FLORIDA STATE OF FLORIDA ' ' -
COUNTY OF �G( � COUNTY OF _ // �
The fnraging instniment was agknowledged before me The forming instrt�■*+Pnt: aclrgrowledged b-fare me
that'of 2Q% y thi&.lx:_-day o : � Df ,by
(Name of person acknowledging) (Name of person acknowledging)
.(5i atur of Notary Public-State of Florida) (Si atu of Notary Public State of Florida}
Personally Known -I-OR Produced Identification Personally Known ✓ OR Produced identification
Type of Identification Produced S amatw T pe of Identification Produced
NOTARC - Juliet Law
_STATE OF FL d o
Commission No. �`O �-� •• ksion No. Cs� 130TARYPIlBLI
+; GE 046735 - a STATE OF"R
!
Expires 1 /13F2Q20
rw %w E*res 11113121 0
Revised 0711512014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
9'dZtCC9Z2ZLLMV1 e0t,:M 26 66 Inf