HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTECD
Date- / � PermitNu`.' L l_l_ ` `, -' 2018__r':� : -- Building Permit Applicatio
Planning and DevelopmentServices epartmentBuilding and Code Regulation Division unty FL2300 Virginia Avenue,Fort Pierce FL 34982 rPhone:(772)4624553 Fax:(772)462-7.578 Commercial
PERMIT APPLICATION FOR: Electrical -j
PROPOSED INPROVEMENT LOCATION:
Address: 7 1
Legal Description:
Property Tax ID#f: 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 at each address
CONSTRUCTION INFORMATION:
Additional wor tve pertormed under t is permit—cMck all appy:
0HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric Plumbing Sprinklers E Generator Roof
Total Sq.Ft of Construction: S .Ft.of First Floor.
Cost of Construction:$ , l U��� cid Utilities:�SewerESeptic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address: $000 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: 772-878-3347
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$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LEEN LAW INFORMATION:
DESIGNERIENGINEER: NotApplicable MORTGAGE COMPANY: Not.applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip-- Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: r/Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permitto do the workand installation as indicated.
I certify th at 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 authorizethe 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 Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,l 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 bwiding permit applications are exemptfrom 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 recordin aur Notice of Commencement.
Signa re of Owner/Agent/Lessee Sig ure of Contractor/License Holder
STATE OF FLORIDA - STATE OF FLORIDA
COUNTY OF COUNTY OF
-fhe farming instniment was�knowledgMd before me The far ing instnsmPnt ack,nowiedged before me
thiay of 201 thay o - Dfby
(Name of person acknowledging} (Name of person acknowledging)
11 A
{SF atur of Notary.Public-State of Florida) (Si atu)b of Notary Public-State of Florida)
Personally Known L--'-OR Produced Identification Personally Known i--- OR Produced Identification
Type of Identification Produced t T pe of Iderrtification Produced
NOTARY. IC JURet Law
a _STATE OF FL
Commission No. �` �-� WS
iOn N0. ��d NOTARYPUI3U
a G 046735 - 9 STATE OF FLR A
int 1 11312020
Revised 07/I5/21]14 v • s�Nce v F-�►ras 1111312 a
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW ' REVIEW REVIEW REVIEW
DATE
RECEIVED
ILDATE _
COMPLETED
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