HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0&.,&/ o —20/t? Permit Number: 0
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Building Permit Application
Planning and Development ServicesLucie county, Permitting
LSTLucuic
Svildlr?g and Code Reguidtfon Division
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone-(772)462-1553 Fax: V72)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address-
Legal Description:
Property Tax ID 3414-501-1701-000/9 Lot No.
Site Plan Name: Block No_
ProjectName:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack
CONSTRUCTION INFORMATION:
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Add ItIOn8i work tob-P-nerforrined under this permit—c allt=appy:.
F1 HVAC M Cas Tank Flas Piping Shutters E]Wi'ndows/Doors
Electric FJ Plumbing OSprinklers Generator Roof
Total Sq-Ft of Construction: So. Ft.of First Floor:
Cost of Construction: Utilities;0 Sewer 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: 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 I if different E-Mail:., lawselectricinr.@aol.com
from the Owner listed above) State or County license: ER0000122
If value of construction is$25oo or more,a RECORDED Notice of Commencement is required._
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERIENGINEER:
MORTGAGE COMPANY: Not Applicabie
Name: Name:
Address: Address:
City: State: City: State:
Zip-. Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: I/Not Applicable' BONDING COMPANY: v"Not Applicable
Name.- Name.
Address- Address:
city: City:
Zip: Phone: Zip: Phone:
OWNER1 CONTRACTOR AFFIDVIP.Application is hereby made to
obtain a permit to do the workand installation as indicated.
I cer0j that no work or installation has commenced prior to the issuance of a permit.
SL 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 Association rules,bylaws or and coven-ants that may restrict or prohibit such
structure.Please consult with your Home owners Associaid6n 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 OWN ER:Your failure to Record a Notice of Commencement may result in your paying twice for
idiprovements to your property-A Notice of'Commencement must be recorded and posted an the jobsite
before the first inspection.If you intend to obtain financing;consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
Signo re of owner/Agent/Lessee Sig5gure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ��/�,e 4, COUNTY OF--
The fr-e-frig instrument 1, . PgkinowledEre-d before me The foraoing instrument wa acknowledged before me
thic--O&��day of 2047by thive4�p�ray Of:
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(Name of personacknowledging) (Name of person acknowledging)
(SiWtur?of Notary Public-State of Florida) (5-1kA56-uof Notary Public-State of Florida
Personally Known &/`OR Produced Identification Personally Known .�- OR Produced Identification
Type of Identification Produced— 41" JUW Type of Identification Produced
NOTARY PO 3LV
Juliet Law
Commission No.6,=(,-Z�� STATE OF F.O!Rftaissfon No. G QV
Conyn#GGG Ims NOTARY PUB 'I
STATE OF FLR�R A
Expires I IL�342()2()
Revised 0711512014
RENEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
I COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
COMPLETED
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