HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number
RECEIVED
Building Permit Application OCT 0 2 2015
Planning and Development Services
Lucie
Building and Code Regulation Division ST. County, Permitting
2300 lrrginia Avenue,Fort Pierce FL 34982
Phone:(772)462-3553 Fax:(772)452-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical a
PROPOSED INPROVEMENT LOCATION:
Address 1, 73 4 Z, ` 1 1
Legal Description:
PropertyTax lD#: 130j-111-0001-0001 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
rDETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
[CONSTRUCTION INFORMATION:
�rt,tiona work to be nertormied under tis permit—check all that appy:
L=EHVAC L=1 Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric F]Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: Sq-Ft of First Floor:
Cost of Construction:$ l_ePOC2, eer utilities:ESewer Elseptic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Wynne Building Corp_ Name: .lames W Law
Address: 8000 S US#1 Suite 402 Company: Law's Electric, Inc.
City: 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-Niail: 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 S required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIG1UERfENGINE R: Not Applicable MORTGAGE COMPANY.- ziNotA
pplicabie
Name:
Name:
Address: Address:
City State- City- State-
Zip: Phone: Zp: Phone-
FEE SIMPLE TITLE HOLDER: _,/NotApplicable BONDING COMPANY: r/NotApplicabie
Name: Name:
Address: Address:
City_ City,-
Zip: Phone- Zip: Phone-
OW NERI CONTRACTOR AFFIDVIT:Application is hereby made to obtain a pera itto do the workand 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 a�t�,orize 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 prohlbitsuch
structure.Please consult with your Home Owners Associatibn and review your deed for any resWictionswhich may apply-
16 consideration of the granting of this requested permit 1 do hereby agree that 1 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,watts,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
irnprovemeirts to your prapert:y.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
commendng work or recardingvour Notice of Commencement.
Sgna re of Owner/Agent)Lessee Sig ure of Contractor/license Holder
STATE flF FLORIDA ,/ STA'T'E OF FLORIDA '
COUNTY O COUNTY OF
The forgoing,instru, t was-acknowledged before me Thefareoing irutrn� �s atrowIedged before me
this.c3.oay of
20/Eby thi qday,
vS�a ; 7dbY
X171 Fes,_
(Name of person acknowledging) (Name of person acknowledging I
c _
( i atur of Notary Public-State of Florida) (Sihn-a6uh of Notii y Public-State of Florida}
Personally Known OR Produced Identification Personally Known f--- OR Produced Identification
Type of Identification Produced i Type of Identification Produced
< IC ON Juud Law
Commission No. _STATE OF I LOW No_ GLz� (oma �
046735 o ;VOTARY PUBLIC
We -- Expires 1,11312020
STATE OF FLCt
Revised 07115=14 9 . EWil+es 111'1312 0
[DATE
EVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVfEW REVIEW REVIEW
CEIVED
ATMPLETED
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