HomeMy WebLinkAboutBuilding Permit Application ALL PPP BLE INFO MIST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: :IL, /.7-. .,,,_2-(V 9 Permit Number: 1,9U V---- ii,2 i 7
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Building Permit ApplicatiOn.
i Planning and Development Services
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4. Building and Code Regulation Division
2309 Virginia Avenue,Fort Pierce FL 34982
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li Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
! PERMIT APPLICATION FOR: Electrical
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i PROPOSED i NPROVEMENT LOCATiON: 1
Address: 3/ - 33 , ,. ,_ 1 , ...4., ..../..) • I
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Legal Description:
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Provrty Tax ID if: 3414-501-1701-000i9 Lot No.
1 Site Plan Name: Block No.
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Project Name:
] Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTiON OF WORK:
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Replace meter center with a combo pack _ --"/ • ---40,
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1' CONSTRUCTION INFORMATION:
iko.Mena wor to .e e orme• un o er t is permit—c ec a ,. app y:
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HVAC Gas Tank Gas Piping Shutters 11 Windows/Doors
' E Electric 0 Plumbing Sprinklers F Generator ri Roof
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• Total Sq.Ft of Construction: S9„Lti of First Floor:
Cost cf Construction:SHP ,LUtilities:I 'Sewer 1-1 Septic Building Height: i
1 I OWNER/LESSEE: CONTRACTOR:
I I 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
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Zip cod*: 34952 Fax: City: Port St.Lucie State: ft-
Phone No. 772-878-5513 . Zip Code: 34952 Fax: 772-878-334 I'
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E-Mail: Phone No. 772-971-4512 I
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•=ill in-Jae s!Inple'Titie Holder on next cage'iir differert E-Mail: lawselectricinc@aoLcorn i I
-2rcm the Owner listed arocve) State or County License: ER0000122 11
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:1 if value o: construction is 325or)or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: r
Not Applicable
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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.
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St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structurewhich 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 your Notice of Commencement.
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Sign' re of Owner/Agent/Lessee ,,' ig,.ture of Contractor cense o der
STATE OF FLORIDA ifi • , . STATE OF FLORIDA ...„,<Cic4e.d...6.,.
COUNTY OF .. - ,a.e.,...e.) COUNTY OF
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The for ing instrumerrAmas asnqwledges)before me The for ng instrume t was acknowledgetlgefore me
this/it- day of --JP,/0*9,20/9 by this / day of 20/7-by
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(Name of perso acknowledging) (Name of person acknowledging)
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6,11/1 /iaLk 4dalf,
(Signa ure o(Notary P #0" "fa e of Florida) (Signet re iof Notary Piltate of Florida)
.er .------------
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
. • Beverly J.Proske Beverly J.Proske
Commission No. ;.,1, ig.z..f , • --y PUB(Silal) Commission No. 4..L. vi.;•._-_. NOTARXSIMJC
itoe':to STATE OF FLORIDA Nilo`"i 3-4 STATE OF FLORIDA
- AO -Cornrrdt GG262780 ..'411'`rt--'41 Cerra*GG262780 ,
Revised 07/15/
I' fit,;t1; Expires 912612022 1 1%
%a 1 Expires 9,2612022 ,I
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER 1 REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED .
DATE
COMPLETED
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