HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: y Permit Number: �q
RECEIVED
Building Permit Application JAN 16 2019
Planning and Development Services
60ding and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address:
Legal Description:_
Property Tax[D#: 130111-0001-00014 Lot No.
Site Plan Name: Block No.
ProjectName:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center With a combo pack at each address
CONSTRUCTION INFORMATION:
ACiamon;3tiib-rV-t-ob-epe-rtnrmed under this permit—check all J=apply:
F]HVAC FIGas Tank MGas Piping UShutters E]Windows/Doors
EE]ectft Plumbing ElSprinklers OGenerator Roof
Total Sq-Ft of Construction: Sq.Ft.of Firk Floor:
Cos-z of Construction: utilities:F]_Sewer[Septic Building Height:
OWNERILESSEE: CONTWCTOR;
Name Wynne Building Corp- Name: James W Law
Address- 8000 S US#1 Suite 402 Company: Law's Electric,Inc.
City: Pon St Lucie State: FL Address: 218 Beach Avenue
Zip Code: 34952- Fax: - City: Port St.Lucie State: FL
Phone No. 772-878-6513 Zip Code: 34952 Fax: 772-878-0347
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.
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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 mads to obtain a permitto do the workand installation as indicated-
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Coun 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 Assbciaticin 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 bultding 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
commencinR work or recording-your Notice of Commencement.
sign re of Owner Agent/Lessee re of Contractor)'0cense Rorder
STATE OF FLORIDA 4 STATE OF FLORIDA r
COUNTY OF
COUNTY OF �� " C �
The for 1119 instru t mas acknowledggg!before me The foryng instrumep J?e-fore me
this I this day
I I was acknovviedgitI,
7 day Z7AQA(,7 2UJ_by day of 20J-7—by
(Name of pers, acknowledging) (Name of person acknowledging)
lozk
(Signaeure of Notary P a6 of Florida) (Signal Jre*f liotary Pjgt��cn 6te of Florida
Personally Known OR Produced Identification Personally KnownL--�OR Produced Identification
Type of Identification Produced Type of Identification Produced
Bowly J.Pmske Beverly J.prosks
Commission No. 4th_*b_unTARY PUBMal) Commission No. t4OTARJSW}IC
STATE OF FLORIDA STATE OF FLORIDAL
an"0 rG 28M A GG26VBO
Revised 071151EXPIMS SM612022 W, I-Ex;Pires 9t2et2022
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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