HomeMy WebLinkAboutBuilding Permit Application ' f
ALL APPLI ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ..Z� Permit Number:.
p: RECEIVED
Building Permit Application' .
Planning and DevelofimentServices AU G 13 2018
Building and Code Reguiati'on Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie Gemhtti,ftrnlltting
Phone:(772)462-1553 Fax: (772)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.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack C
CONSTRUCTION INFORMATION:
Additional work to be riertorme un ert is permit—check all appy:
HVAC Gas Tani. ❑Gas Piping _Shutters Windows/Doors
LI Electric ElPlumbing ' OSprinklers Generator Roof
Total Sq_Ft of Construction: So. Ft.of First Floor:
Cost of Construction:$. f1 �. UC Utilities:Sewer Septic Building Height:
OWN ERAESSEE: CONTRACTOR:.
Name Wynne Building Corp. Name: .lames W Law
Address: 8000 S US#1 Suite 402 Company: Law's Electric, Inc.
Cid 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 nee 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:
DESIGNER1ENGINEER: _Not Applicabie MORTGAGE COMPANY: Not Applicable
Name: Narne•
Address Address:
City: State: City: State:
Zip: Phone: Z, Phone:
FEE SIMPLE TrFLE HOLDER: r Not Applicable BONDING COMpA111Y: Not Applicable
Name: Name-
Address: Address:
City: City:
Zap: -Phone:. Zip: Phone:
OWNERI 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 permit
St.turaeCounttyymakes norepresentation that isgranting apermitinn11authorize the permitholder tobulid the subjectstructure
which is in conflict with any applicable Home owners Assocration rules,bylaws or and covenants that may restrict or prohibitsuch
structure.Please consult with your Home Owners Assodatibn and review your,deed for any restrictions which may apply_
iii consideration of the granting of this requested permit,I do hereby agree that 1 will,in all respects,peftrm the work
in accordance vath 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,.
accessorystructures,swimming pools,fences,walls,signs,screen rooms and accessory usesto 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 recordingyour Notice of Commencement.
S ature of Owner/Agent/Lessee ature of Contractor/iicense Holder
STATE OF FLORIDA . LUCIE STATE OF FLORIDA
COUNTY OF COUNTY OF ST.LUCIE
Thefo Ping instrument was acknowledged before me The fo Ding instrumenttwas acknowledged before me
th' ay of • 2Q1by thi ay ZIIiiy
JAMES W LAW JAMES W LAW
,[Name of person aekmaizbedging 1 (Name of person al ltntbledging)
(Signatu a Notary Public-State of Florida} (Signature dNotary Public-State of Florida}
Personally Known '•✓ OR Produced Identi lication Personally Known ✓ 'OR Produced Identifusition
Type of Identification Produced Type of Identification Prodoued
Cornmisdon No. I Juliet Law Commission wo.Z-�/5t�7A {Seal}
NOTARY Juliet taus
F FLORIDA ,� VARY PLIBW `
RMsed 07/1512014 a Canyro
11/ i ,. OFFLORgA
Oresxp rea fill REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTI E MAU o�����RDVE
COUNTER REVIEW REVIEW. REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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