HomeMy WebLinkAboutBuilding Permit Application 1
• ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ...18,0 , /4 —2:4912 Permit Numb-r.:_____JX(971.9--- '7
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vig........ Building Permit Application
SEP 1 2018
Planning and Development Services
Building and Code Regulation Division Permitting
2300 Virginia Avenue,Fort Pierce FL 34982 Department
Phone:(772)462-1553 Fax:(772)462-1578 Commercial 'esc..... , _
itientiele Obi 1 lily, FL
1 PERMIT APPLICATION FOR: Electrical
- -'
PROPOSED INPROVEMENT LOCATION:
Address: •--,T,76(i )1i,e7./ 0;,_,I)
/
Legal Description:
1 . : ....._
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 at each address 1
CONSTRUCTION INFORMATION:
Additional work to biggrtormed under this permit—check all that apply:
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EIHVAC I !Gas Tank EIGas Piping L.._Shutters 11 Windows/Doors
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E/ Electric !Plumbing E Sprinklers El Generator 1- Roof
Total Sq. Ft of Construction: Siai of First Floor:• t
Cost of Construction:$... .). 0C, Utilities:i 'Sewer 7 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.
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City: Port St.Lucie State: l- Address: 218 Beach Avenue
Zip Code: 34952 Fax: City: Port St_ Lucie State: FL
Phone No. 772-878-5513 i • Zip Code: 34952 Fax: 772-878-3347
E-Mail: 1 Phone No. 772-971-4512
Fill in fee simple Title Holder on next page(if different E-Mail: lawselectricinc@aoLoom
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 LAW INFORMATION:
DEsiGNER/ENGNEER: V Not Applicable MORTGAGE COMPANY: ;-----Not Applicable
—
Name:' Name:
Address: • Address:
City: State: City: " ' State: .
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: V Not Applicable BONDING COMPANY: L-/Not Applicable
Name: • Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
i certify that no work or installation has commenced prior to the issuance of a permit
St.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 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 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 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 recording your Notice of Commepcement.
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Signviphr---/1"-V 7iri: •(---/ . - /ter les7, ‘2 — !
re of Owner/Agent/Lessee Sign- re of Contractor/License Holder
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STATE OF FLORIDA . STATE OF FLORIDA inle,,f -
COUNTY OF .6e1,e(,ee., COUNTY OF --,,C1- . .....,(6."..-e.----
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The foreoing instrument uses acknowledged before me The forgoing instn"TIP was ckpowledged before me
this.ZaZday of 4f. o 4- . Ki.a..by thiE /‘-,g day 0_4 by
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(Name of person acknowledging) (Name of person acknowledging)
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,„,. ..ii.f.. ,MIIP . ,,V. , 1.-----)
( I:. atur-of Notary Public-State of Florida) (Si atu of Notary Public-State of Florida)
Personally Known 1------OR Produced Identification Personally Known i----- OR Produced Identification
Type of Identification Produced ' Juliet Law
•••
Type of Identification Produced
- - '..• 1• 1- PUBLIC
.,STATE OF FLOWssion No, g-C) .... _ _ - Juliet Law
Commission No.C7--G-'en.44;7_9:4- _ -c-c, A Yi...." '.': NOTARY PUBLI•.
.1 Comrre GC 046735 - G:.Iii.,'11"-i j.i..'';-.:* . STATE OF FLq- .A
% Expires 1 V13/2020 - -......o..:ic,.- •
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• • /4tt i ' Expires 11/13(2020
Revised 07/15/2(114
DRAEVTEIEWS
RECEIVED
DATE
COMPLETED FRONT ZONING
COUNTER REVIEW SUPERVISOR PLANS
REVIEW REVIEW
VEGETATION SEA TURTLE ' MANGROVE
REVIEW
• REVIEW REVIEW
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