HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:_ : 1� Permit Number: _R CEIVETT--
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�' Building Permit Application
Planning and Development Services ST. Lucie County, Permitting 4
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
PROPOSED MPROIEMENT LOCATION:.
Address: �
Legal Description:
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
CONSTRUCTION INFORMATION:.,
Additional work to e nartormed under this permit–check all appy:
R
aWindows D ors❑HVAC LGas Tank Gas Piping —Shutters
Electric 0 Plumbing MSprinklers 11 Generator Q Roof
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities:OSewerFleptic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US#1 Suite 402 Company_ Law's Bectric, Inc.
City: Fort 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: 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 recordingvour Notice of Commencement.
of
Si ture of Owner/Agent/Lessee Si ature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFCOUNTY OF
The foring instrum nt was acknowledgedbefore me The f r ing instru nt was cknowledgecefore me
thisday of c 20,f�by this day of U e 20�8LIby
(Name of perso cknowledging) (Name of person acknowledging
(Signatu a of Notary Publi f Florida) (Si nature of No lic-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
�►alr evedy Bonrerly .
Commission No. ROTARY Plt9� Commission No. t NOTARY PUII,,
+STATE OF FLORIDA STATEC0111111 06262780
OF FLORIOfA
:Comm*GG262780
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Revised 07/15/20c 18 0 Expires 9126/2022 iN a 11 Expires 9126!20
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED