HomeMy WebLinkAboutBuilding Permit Application . .-
ALL APPUCABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dat-Ilk / i de` .—..? •. __ :, .er Permit Number: I CP r9.—
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Building Permit Application'
Planning and Development Services
Building and Codefiegulation Division
2300 Virginia Averlue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical E
PROPOSED INPROVEMEF,LOCATION:
Address: .. •cf— ' .._,AP-..•' dp: ,• .,( 0
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Legal Description: •
Property Tax ID#: 3414-501-1701-000/9 Lot No.
Site Plan Name: . Block No.
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Project Name: , . .
Setbacks Front • ''' --.43acti!-:'' : Right Side: Left Side:
1 . DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack ,022e_42.1)
kv- cAL).8,es 116 q 11 0e 5. o
CONSTRUCTION INFORMATION:
• Additional work to brcfiLliformed under this permit—check all a..na apply:
I
E1HVAC I Gas Tank Gas Piping 'Shutters ri Windows/Doors
,E• Electric flPlumbing Sprinklers El Generator F Roof
Total Sq_Ft of Construction: S$Iti of First Floor:
Cost of Construction: C-), C-1• c--) Utilities:I 'Sewer Septic Building Height:
' OWNER/LESSEE: CONTRACTOR:
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 I
Zip Code: 34952 Fax: City: Port St.Lucie State-. FL-
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Phone No. 772-878-5513 _ Zip Code: 34952 Fax: 772-878-3347 :1
E-Mail: Phone No. 772-971-4512
Fill in fee simple Title Holder on next page(if different E-Mail: lawselectricinc@aoLcom 1
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: I
Zip: Phone: Zip: Phone: I
FEE SIMPLE TITLE HOLDER: V Not Applicable BONDING COMPANY: r/Not Applicable
Name: Name:
Address: Address:
City: City: •
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permitto do the work and installation as indicated.
f.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 theermit 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 1
structure.Please consult with your Home Owners Association and review your deed far 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_
Thefollowing building permit applications are exemptirom undergoing a full concurrency review:room additions;
accessory structures,swimming pools,fences,wails,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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Signa re of Owner/Agent/Lessee Sig re of Contractor/License Holder
STATE OF FLORIDA . STATE OF FLORIDA -
COUNTY OF -l.2 `. �l -e COUNTY OF �(,6
The reaing in --tw s.acknowledged before me The f___ instn' was acko wiedged before me
1 thi qday o - fi�/. t ,? py th`f ..tfay O by
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(Name of person acknowledging) (Name of person acknowledging)
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( i atu of Notary Public-State of Florida) (5i: atu}h of..Natary.Pubh 'State of Florida)
Personally Known de----.OR Produced identificationI Personally Known i OR Produced Identification
Type of Identification Produced • .S '_..Identification ,..,, Law TypOe of Identification Produced
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STATE OF-im • --Juliet Law
Commission No_ g-d4 7-4$ ;- R Rssion No_ -&C �'_ NOTARY PUBLI+
• - �: G`omrii#e2040735 _ ..°"-'•,....4---; STATE OF Fig"
. •fres 11/13/2020 -�....0...4"-t. - ,�. . - !
- • •wilt1 9 � Expires 1111312 i r 0
Revised 07115/2014 -
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED .
DATE '
COMPLETED -
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