HomeMy WebLinkAboutBuilding Permit Application _
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date. 144-7) l',=,.Z -2-evg
Permit Number: LV_
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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
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PROPOSED INPROVEMENT LOCATION:
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Address:
-- N'n--6-Y. - 4, -E.1---
, 1
Legal Description:
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Property Tax ID#: 3414-5014701-000/9
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
CONSTRUCTION INFORMATION:
A.ittiona wor to .e e orme. un•er t Is permit-c ec a .., appy:
OHVAC Gas Tank Das Piping Shutters [1 Windows/Doors
_
. iEl Electric El Plumbing
— ii: Sprinklers 1.21 Generator r-- Roof
Total Sq.Ft of Construction: Sot_.Ft.of First Floor:
Cost of Construction:$ /0k)Z%06) Utilities:L_I Sewer riSeptic Building Height:
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. OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
8000 S US#1 Suite 402 Law's Electric, Inc.
Address: Company:
City: Port St.Lucie State: FL Address: 218 Beach Avenue
Zip Code: 34952 Fax': City: Port St.Lucie State- FL
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Phone No. 772-878-5513 I Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No. 772-9714512
Fill in fee simple Title Holder on next page(if different E-Mail: lawselectricinc@aoLcom ,
from the Owner listed above) State or County License: ER0000122
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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: i---"-Not Applicable
Name: Name:
Address: • Address:
City: State: City: State:
Zip: Phone:
,P 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 Sign ure of Contractor/License Holder
STATE OF FLORIDA ��ji STATE OF FLORIDA y
COUNTY OF `L eft e:/ COUNTY OF /?�Z,[.Pr-1,e-
The foreoing instr ment was acknowledged before me The foreoing inst 'm1 ntwas ackpowledged before me
this/ flay of ,20/R ,by thi -day of; a./&(y,;if?"P.V 20f :.by
(Name of person acknowledging) (Name of person acknowledging)
,(S! atur of Notary Public-State of Florida) (Si atu of Notary Public-State of Florida)
Personally Known ✓OR Produced Identification Personally Known 1- OR Produced Identification
Type of Identification Produced . - Juliet '- ' T pe of Identification Produced
.-z. f NOTARY PUBLIC Juliet
Law
p �� __STATE OF FL 3 Psion No. 6-6.aV6 l.3S '4.-
Commission No.� -; . - .
0 t•' Commit GC 046735- _ NOTARY Pl18UC
s1.,.� Expires 1'/13/2020 .4 `` .' STATE OF FLTI)A
SINCE s Expires 11/13/2020
Revised 07/15/2014 -
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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