HomeMy WebLinkAboutBuilding Permit Application ACL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: f �� Permit Number:_ O
Building Permit Application
Plannfng and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:,(772)462-1553 Fax: (772)462-1.578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSEb INPROVEMENT LOCATION:
Address_
Legal Description:
PropertyTax ID#l: 1306-111-0001-000i�0 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
I
CONSTRUCTION INFORMATION:
Additional work to be nP rmed under this permit—check all that appy:
HVAC Gas Tank Gas Piping _Shutters Windows/Doors
Electric ED Plumbing OSprinklers Generator Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ Cs U 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.
i S
City: Port SL Lucie tate: Address:
FL 218 Beach Avenue
_
Zip Co.de: 34952 Fax: City: Port St.Lucie State: FL
Phone No. 772-878-5513 Zip Code: 34952 Fax: 772-878-3347
j E-Mail: Phone No. 772-871-4512
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 Fs required.
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ISUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERIENGINEER: vFqot 'Applicable MORTGAGE COMPANY- t!Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone: — I
FEE SIMPLE TITLE HOLDER: Not Applicable' BONDING COMPANY: vl�kot Applicable
Name: Name:
Address- Address:
City: City:
Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby madeto obtain a permit to do the work and installation as indicated.
I cerlKythatho work or installation has commenced priorto the issuance of a permit.
St-Lude Count 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,bViaws or anti 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-
lei consideration afthe 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_
Thefollowing building permit applications are exempt from undergoing a full concurrency review:room additions;
accessory structures,swimming pools,fences,walls,signs,screen roams 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 tender or an attorney before
commencin work or recordin&Vour Notice of Commencement
Sign re of Owner/Agent/Lessee Sg-�qure—of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTYCIF COUNTY OF
The forgoing instrument was ggknowledged before me The forgoing lnstnlrnpq�x was j"awledged before me
2()/&by 9 ;Z - � y
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(Name of person admowl edging)
(Name of person acknowleft ing I
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(533jiaifu? of Notary Public-State of Florida) (Sikffatufe of Notary Public-State of Florida)
Personally Known OR Produced.1dentffication Personally Known 'f-- OR Produced identification
,,a,. 31111917taw Identification Produced
Type of Identification Produced T eofid
Y,F Ace Judet Law
STATE OF FLC)Rftslcn No
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.64 % .. ----7S S- NOTARY�Pusuic
Commission No- 6X 4& comr"#GC W735 STATE OF FLRR I A
Ex ares 1,113/2020
awm 1111312 0
Revised 0711512014
REVIEWS ZONING FRONT SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED ECEIVED
DATE
-COMPLETED
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