HomeMy WebLinkAboutBuilding Permit Application ALL APPLTTC_ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:� 1/ �� r dr`c7t Permit Number. 1� a ,,
RECEIVED
MAR 0 4 2019
Building Permit-Application
Planning and Development Services ST. Lucie county, Permitting
Building and Cade Regulation Divislon
2300>rrginfo Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-3578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical J
PROPOSED INPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID##: 0 120 - Depelf Lot No.
Site Pian fume: Block No.
Project dame:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
[CONSTRUCTION INFORMATION:
�-`ACIdmonal wor to e e Orme under t is permit-c ec a appy:
UHVAC U Gas Tank ❑Cas Piping Shutters ❑Vltindows/Doors
OV Electric El Plumbing []Sprinklers. Generator Roof
Total Sq.Ft of Construction: SQ.Ft.of First Floor.
Cost of Construction:$ '. L 0td, zoo _ Utilities: Sewer Septic Building Height:
OWNERJLESSEE: CONTRACTOR:
Name Wynne Building Corp: Name: James W Law
Address.. 8000 S US#1 Suite 402 Company: Law's Electric, Inc.
Ct i. Port St.Lucie State. FL Address: 218 Beach Avenue.
Zip Code: 34952 Fax: City: Port St.Lucie State: FL
Phone No. 772-278.5513 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No. 772-971.4512
Fill in fee simpleTltle Holder on next page(if different E-Mail: lawselectricincPPaol.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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I 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: -l/Not Applicable BONDING,COMPANY: r%Not Applicable
NarriL: 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.
1 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 the permit 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-
Irl consideration of the granting of this requested permit,I do hereby agree that l will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments_
Tile 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
irhprovements to your property.'A•Notice of Commencement must be recorded and posted on the jobAte
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recordinayour Notice of Commencement.
Signore of Owner/Agent/Lessee Sign re of Contractor/License Holder
STAN OF FLORIDA - STATE OF FLORIDA
COUNTY OFF_ -Fd COUNTY OF
thefnrq5inginstrunisnt was a tnowledged before me The farpoing instnimpnt3was ac. owledged before me
thi ,� ' ay of L201 y thi�L kayo ; _ZD ,by
(Name of person acknowledging) (Name of person acknowledging)
1
(Si atur of Notary Public-State of Florida) (Sihnatuib of Notary Public-State of Florida)
Personally Known L--�OR Produced.Identification Personally Known OR Produced Identification
Type of Identification Produced 4U0. ► Type of Identification Produced
TdTAKrF IC
Commission No. �' : - STATE C0mrnFOF FLOOR j Sion No. �CrD _ - ��� Law
NOTARY P1.f8L1
a STATE OF FL A
Expires 1 113/2020
Revised 07/3.5/2014 9 _ ��iill 3l2 0
REVIEWS FRONT ZONING SUPERVISOR' PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
QATE
COMPLETED
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