HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i / ,/,./ J‘) . .,4 /g" Permit Number: /I' 0 f- DS 1,) .
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_. _ . Building Permit Applicatio, 810Z S 1 cl3S ,
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Planning and Development Services
Building and Code Regulation Division2..`:i.T
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2300 Virginia Avenue4
,Fort Pierce FL 34982 „,„ ,
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Phone: (772)462-1553 Fax: (772)462-1578 Commercial : i•eirlAia
PERMIT APPLICATION FOR: Electrical
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PROPOSE() INPROVEMENT LOCATION:
/3 4" 1..It jizz_z4f eiTe7g
Address:
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Legal Description:
Property Tax ID#: 1306-111-0001-000/e :. Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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Replace meter center with a combo pack
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CONSTRUCTION INFORMATION:
AN.1-bona war to se e orme. un.er t is permit–c ec a .. app y:
1
F1HVACGas Tank Gas Piping Shutters ED Windows/Doors I
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[ Electric i- Plumbing I 'Sprinklers _ Generator Roof
Total Sq. Ft of Construction: '' S . Ft.of First Floor:
Cost of Construction:$ /c". 63C:,, e_.)e.) Utilities: Sewer F Septic Building Height:
- 1 /
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp_ Name: James W Law
Address: 8000 S US#1 Suite 402 Company: Law's Electric, Inc.
l City: Port34S2t. Lucie State: FL Address: 218 Beach Avenue
Zip Code: 95
Fax: City: P
Phone No. 772-878-5513
Zip Code: 34o9rt5S2t. Lucie State: FL
Fax:
772-878-3347
E-Mail: Phone No. 772-971-4512
Fill in fee simple Title Holder on next page (if different E-Mail: Iawselectricinc@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 LAW INFORMATION:
DESIGNER/ENGINEER: V Not Applicable MORTGAGE COMPANY: r•-'-Not.4pplicab(e
Name: Name:
Address: Address:
City: State: City: ' State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: V Not Applicable - BONDING COMPANY: r/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 recordingyour Notice of Commencement.
Sign re of Owner/Agent/Lessee Sig ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA ' ' .
COUNTY OF ��' �fL�,l) COUNTY OF
The foreoing instrument was acknowledged before me The foreoing instn'mertwas ckpowledged before me
thisl6 day of1 ,20/g by this /6 day of- . C - 2014,:.by
(Name of person acknowledging) (Name of person acknowledging)
•
(Sr atur of Notary Public-State of Florida) (Si atu of Notary Public-State of Florida)
Personally Known ✓OR Produced IdentificationPersonally Known ✓ OR Produced Identification
Type of Identification Produced .t : Juliet12w Type of Identification Produced
• NOTARY PUBLIC J��
Law
Commission No.6-& 4 'Z9 �_STATE OF FLO sion No. G&O _ �� `' NOTARY PUBLIC
�: Comm#GG 040735 - �r[fr : STATE OF RR- )A
E 11% Ex.ares 1'/13/2020 ...ter
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Revised 07/15/2014 • •istE s Expires 11/13[2[120
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
• COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED •
DATE
COMPLETED