HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: (11"w Permit Number.
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RECEIVED.
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Building Permit Application
Planning and Development Services JAN 15 2019
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34992 ST. Lucie County, Permitting
Phone:(772)462-1553_ Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical 0
PROPOSED INPROVEMENT,LOCATION:
Address:
Legal Description:
Property Tax ID#: 130111-0001-0001 0 k 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
ackCONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a appy:
1=1HVAC E]Gas Tank F]Gas Piping _Shutters a Windows/Doors
Ll Electric Plumbing Sprinklers E Generator F]Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ Utilities: Sewer Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: Jaynes 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: 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 Halder on next page(if different E-Mail: lawselectricinc@aol.com
from the Owner listed above) State or County License: ER0000122 I
1
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: —NotApplicable- 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 madeto obtain a permitto do the work and installation asindicated_
I certify that no work or installation has commenced priorto the issuance of a permit.
St.Lucie jCourttvmakes no representation that is granting a permit will authorize the armit holder to build the subject structure
which is in convict with any applicable Home Owners Association rules,bylaws or an9covenants that may,restrict or prohibit such
structure.Please consult with your Horne Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I dc 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 your Notice of Commencement.
S7igp'tune iii_0wn6FJ Agentl Lessee 6 s0ature of Contractor/License
STATE OF FLORIDA y STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrurnpant was acknowledged before me Thef r Ing instrunWtwas cknowledged,,beforeme
T
thfsJ%day of IAAIJ"Y- _,2ULbv —by
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{Name of perso cknowledging) (Name of person acknowledging
(Signatu e of Notary Publi /of Florida) (Si nature of No6oklfc-State of Florida
Personally Known OR Produced Identification Personally Known L-__'CR Produced Identification
Type of Identification Produced Type of identification Produce
Beverly J.Proske Iqy BewdY J.V1`05KO
Commission No. j1J&-4%NOTARY FU��&)_
Commission Na. -0TARYPLkq6STATE I_t_1JVrq1LJP%
STATE OF FLORIDA Cwa*GG26278D
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Revised 0711512alf Expires 912612022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
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COMPLETE
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