HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: .)?4•?,). /4 L21 Permit Number: 49 it-- (7a011
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.17::.. �.._.�: - Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone:(772)462-1553_ Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical 0
PROPOSED INPROVEMENT LOCATION:
Address: / 71/
Legal Description: '�(
Property Tax ID#: 1306411-0001-000LO ; 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
CONSTRUCTION INFORMATION:
h ..rt►ona wor to •ee e ormes uns er t is permit—c ec a I, appy: I
HVAC I I Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
' ElElectric 0Plumbing nSprinklers L I Generator I I Roof
Total Sq.Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ , ,,j(,d• OCA Utilities: _Sewer ElSeptic 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.
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-Mail: 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 is required.
1
,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: V Not Applicable MORTGAGE COMPANY: 1---""Not Applicable
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 toanother 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 Commencement.
' ,/7/1 e'Vr4
Sign re of Owner/Agent/Lessee Sign re of Contractor/License Holder
STATE OF FLORIDA -��J/ TATE OF FLORIDAji' ,..(,,,, ,er___1„,e,.
-
COUNTY OF Ji. ..t,44.. .0 COUNTY OF
The forgoing instr molt was acknowledged before me The foreoing instrtmrntwas ac powledged before me
this Zday of '.. 20/ by this/se--slay of,- -- ../A- 14,'P ')-L2.ahJ 201. aby
l Jfrtl-ac 0 .4./4(.4)
(Name of person acknowledging) (Name of person acknowledging)
__ --- -1.Th '
r-- _- ,.),14., ;: '
Lam,
.(Sbiltur of Notary Public-State of Florida) (Si atu of Notary Public-State of Florida)
Personally Known d------"OR Produced Identification Personally Known i---- OR Produced Identification
Type of Identification Produced Juliet-L1tnr Ty pe of Identification Produced
NOTARY PUBLIC ... Judet Law
Commission No.l��e��7-9-`3� - - T. ,-STATE OF'FLa sion •
No_ 6 O
��� `'; NOTARY Pi1BL!•
,,. , Comm#GC 046735- i[�` � STATE OF FLCr )A
•
Expires l',/13/2020 - __• ,
sNce-s • Expires 11/13!2 e C
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
rDATE
COMPLETED