HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE 1)vF0 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q(r),C21 1
Date:, Permit Number:
'
:REC:EIVED
Building Permit Application 2019
Planning and Development Services
Building and Code Regulotion Division ST. LuPermitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical 0
PROPOSED iNPROVEMENT LOCATION:
Address: 24
Legal Description:
Property Tax ID#: 130s5-111-0001-0001 e> Lot No.
Site Plan Dame: Block No.
Project Name:
Setbacks Front Back: Right Side: Lett Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack
CONSTRUCTION INFORMATION:
Additional work to e e Orme un er this permit—check a appy:
aHVAC 1 Gas Tank Gas Piping _Shutters I1 Windows/Doors
Electric 0 Plumbing Sprinklers I Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ �b• o6 Utilities:)Sewer 0Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. dame: 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: 34952 Fax: City: Port St.Lucie State: FL
Phone No. 772-878-5513 I Zip Code: 34952 Fax: 772-878-3347
E-Mail: I 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$2501)or more,a RECORDED Notice of Commencement is required.
6'd -8826-199-199 LVCC8L8ZLLMVl eZ0:06 % 96 Uef
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 priorto the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize thepermit 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.
Sig6ature of Owner)Agent/Lessee 'nature of Contractor/ icense Holder
STATE OF FLORIDA STATE OF FLORIDA °
COUNTY OF_ ��r COUNTY OF
The foring instrum rnt was acknowledged before me The for ing instrurpent was acknowledged efore me
thisday of 2Q�by this day of.=J U1 20�by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notar7'�tate of Flor a) (Sign ture of Nota iio-State of Florida)
Personally KnownR Produced Identification Personally Known V OR Produced Identification
Type of Identification Produced Type of Identification Produced
boy BwmdyJ.Proske Beveft J.Proske
Commission No. �, NOTARY P( CommissionM�19T�ATEOF
NOTARYPUBLiC (Seal)
�STATEOFFLOMD, FLORI4A
262780
Revised 07/15/2014 ExAims OM2022 AW Expires 912612822
REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED T_
Z-d -89Z 6-699-699 Zt0C2Z9ZLLMVI aZ0:0 6 61, 91, Uel