HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /� Permit Number_
RECEIVED
Building Permit Application
JAN 14 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:'
Address:
Legal Description:
Property Tax ID#l: 3414-501-1701-00019 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: - . .
among work to bene} orme un er t is permit—check a appy:
L_!HVAC U Gas Tank Gas Piping _Shutters a WindowsJDoors
L 1 Electric 0 Plumbing Sprinklers Generator Roof
Total Sq_Ft of Construction: So-
.Ft.of First Floor:
Cost of Construction:$_, d'� �, Utiiities:0Sewer t�1Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James tN Law
Address: 8000 S US#'I Suite 402 Company. Law's Electric. Inc.
City: Port St Lucie State: FL Address: 298 Beach Avenue
Zip Code: 34952 Fax: City: Port St.Lucie State: Fl-
Phone
LPhone No. 772-878-5593 Zip Code: 34952 Fax. 772-878-3347
E-Mail: Phone No. 772-971-4592
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
I f vatue 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 recording our Notice of Commencement.
Si ture of Owner/Agent/Lessee ature of Contractor/ icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �Gf�'.r'.� COUNTY OF
The for ng instrument was acknowledged before me The for ing instru ent was acknowledged before me
this. day of 20�by this day of- 20by
(Name of person acknowledging) (Name of person acknowledging)
(Signature ofNotaryc State of FIG a} (Sign ture of Nota • /ic-State of Florida)
Personalty Known OR Produced Identification Personally Known V OR Produced Identification
Type of Identification Produced Type of Identification Produced
my o Beverly J.Proske r Beverly J.Proske
Commission No. NOTARY PUBW Commission NOTARY PUBLIC (Seal)
e
STATE OF FLORILr< -ESTATE OF FLORIDA
a _
GG262780
Revised 07/15/2014 Expires 9/26/2022 �� Expires 912612022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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