HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: '.2d Permit Number:
RECEIVED
Building Permit Application AUG 0 7 2018 .
Planning and Peve/opmentSen+rces
Building and Code Regulation Division ST,_6deie County, Permitting
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:-
Address: o -
Legal Descripti:)n:
Propert%t Tax ID#: 130,1-111-0001-000/5 C 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
COPdSTRUCTION INFORMATION:
Additional work toe e orme undert is ID
permit—check a apply:
HVAC Gas Tank Gas Piping _Shutters Windows/Doors
Y• Electric 7 Plumbing Sprinklers F]Generator E Roof
Tota: Sq. Ft of Construction: S�Ftj of F€rst Floor:
Cost of Constriction:$ ti��Oc�r fie) Utilities:L )SewerOSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US#1 Suite402 Company: Law's Electric, Inc.
City: Port St. Lucie State: FL Address: 218 Beach Avenue
Zip Zode: 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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F15--SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _,,,Not Applicable MORTGAGE copApANy. „2'riot Applicable
Name: Name:
Address: Address:
CO-, State: Cltr-
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: VNotAppjIcable, BONDING COMPAXY: NotApplicable
Name: Name:
I Address: Address:
City:
gip: Phone• Zip-, Phone:
OWNER/CONTRACTOR AFFIDVITI.Application is hereby rnadeto obtain a pennitto dothe work and installation as indicated.
I cerdfythat no work or installation has commenced priortothe issuance of a permit
,St.Lude Coun
=makes no representation that is granting a Permit will authorize the permit bolder to build the subject structum
Which is in can ' ith an applicable Home Owners Association rules ts hibitsuch
ictw U;.3pp .6 bylaws or and covenark that may.restrict or pro
structure.Please consult. th your Home Owners Associatibn and review your deed for any restrictions With may a0ply_
in consideration of 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,s1gn*s,screen rooms and accessory uses to another non-residential use
WARNING TO OVMER:Your failure to Record a Malice 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
b,
e
ey
the
efirst inspection.If you Intend to obtain financing,consult vAth lender or an attorney before
I commencing work or reco rding your Notice of Commencement.
S atureafownerjAgent/Lessee -0�zture of Contractorilicense Holder
STATE OF STATE OF FLORIDA
COUNTY OF
ST-LUCIE COUNTY OFm-- ST-WCIE
The forg6ing instrument was acknowledge—d.bef dre me 'The-forgoing instcurrijent was acknowledged before me
-0
twis,,-�av of 147Y-11
JAMES W LAW JAMES.W LAW
{Name of pe dging) (Marne of person ftroffledging I
S
of�wnei
ljrp
at
A r-FLORIDAF j
STATE
Lo
or
CC) NTY -
e forgS
Ina instru
1 _4 ay of
Tthh
—{Signa Notary P u�W c-St�ate o f Florida]l- Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known -"' OR Produced Identffication
Type of Identification Produced Type of identification Produced_
Commission NO.ell,�-b—mkz2rDuNet Law Commission iq0.,C=C—Aa1,7-K< (Seat)
J&*kNOTARY M,3- Julm Law
XSIAM OF FLC)R,pAARY PUBLIC
orrinv aGWM- S OF FL IPA
Reyised.07115120.14 EXPI Comn*a 7
Expires 1
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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RECEIVED
COMPLETED
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