HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED tJ 7
Date. Permit Nu b /
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Building permit Applicati JUL 19 2018
Planning and Development Services Permitting Department
and Code RegulaVio9
n Division
2300 Virginia Avenue,Fort Pierce FL 34982 St. LUC'e (niin ,/, FL
Phone:(772)462-1553 Fax:(772)462-1578 Commercial
PERMIT APPLICATION FOR: Electrical J
PROPOSED INPROVEMENT LOCATION:
J
Address:
Legal Description:
Property Tax ID#: 3427-111-0002-000/5 j 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:
ACIditionalworktopepertormed unclert is permit-check all that apply:
HVAC Gas Tank FlGas Piping _Shutters a Windows/Doors
Electric Plumbing OSprinklers 0 Generator 0 Roof
Total Sq.Ft of Construction: S Ft.of First Floor.
Cost of Construction:$ � �G ,e9� Utilities: Sewer[]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.
Citv: 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. 772-971-45.12
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 LIEN LAIN INFORMATION:
DESIGNERJENGINEER: NotApplicable MORTGAGE COMPANY: ,�NotApplicable
Name: Name:
Address: Address-
City_ state: Gty: State:
Zip: Phone- Zip: Phone:
FEE SIMPLE TrrLE HOLD1»R: Not Appjicable BONDING COMPANY: VNot Applicable
Name: Name:
Address: Address-
City_ City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:.Application is hereby madeto obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced priorto the issuance of a permit
St_Lucie County makes no representation that is granting a permit will authorize the permit holder to build the siibjectstructure
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 l 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:roorn additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory usesto another non-residential use
WARNING TO OWNER:Yourfailure 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 recording our Notice of Commencement.
5 ature of Ownerl Agentl Lessee §@hature of Contractor/License Haider
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST.LUCIE COUNTY OF ST.LUCIE
The fo o_ing instrument was acknowledgl'did efore me The forgoing instrument was acknowledged before me
th (day of Cr e 20-z.0 by this*"- day o 20_e_-by
JAMES W LAW JAMES W LAW
(Name of person adkmom fledging) (Name of person ftrivWledging)
(signatu Notary Public-State of Florida) (Signature Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known ✓ 'OR Produced Identification
Type of identification Produced Type of Identification Prodaued
Commission No. E Juliet Commission ova.fr�/� 7-?.� (Seal)
%NOTARY PUBLIC •lu1ier Law
F FLORIAA �, ARY PUBLIC
Revised 07115/2014 COQ r' 1�48i+ , STATEOF FLORtt1A
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION Sl_ATURTLE MAN&VE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE •
RECEIVED
DATI:
COMPLETED
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