HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ' % f Permit Number: -0
LLRECEIVED
- = =- Building Permit Application
Planing and Developmentservices JAN 14 2019
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce Ft 34982 ST. Lucie County, Permitting
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Rest entla
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address: V
Legal Description:
PropertyTax iD#: 3427X111-0002 000!5 Lot No.
Site Pian 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:
nitiona wor to e e Orme under this permit-c ec a appy:
HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric M Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: SFt.of First Floor.
Cost of Construction:$ �' - d c) Utilities. Sewer Septic Building Height:
OWN ER/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: 84952 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 feesimple Title Holder on next page{if different E-Mail: lawselectricinc@aol.com
frorn the Ownelr listed above)' State or County License: ER0000122
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Y;
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 recording our Notice of Commencement.
Sign re of Owner Agent/Lessee igkdtfure of ContractorYCicense Rorder
STATE OF FLORIDA STATE OF FLORIDA �-f
COUNTY OF COUNTY OF �ZZZZ_4'e_,' _
The for ing instrume t as ackn wledggd before me The for ng instrume t was .acknowledge efore me
this day of U 20, by this day of 20by
(Name of perso acknowledging) (Name of person acknowledging)
(Signa ure o NotarZTOR
a e of Florida) (Signat re of Notary PP - tate of Florida)
Personally Known Produced Identification Personally KnownOR Produced Identification
Type of Identification Produced Type of Identification Produced
Beverly J.Proske Beverly J.Proske
Commission No. Y PUBMal) Commission No. NOTARJSW�IC
�74 ESTATE OF FLORIDA —Q oSTATE OF FLORIDA
G262780
Revised 07/15/ ie
EXPIMS 912612022 AftE i - Expires 912612022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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