HomeMy WebLinkAboutBuidlling Permit Application ALL APFLICAKE INFO MUST 3E COMPLETED FOR APPLICATION TO BE ACCEPTED
DatE ,iIi _ Permit Number: C[Or --. LO(
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RECEIVED
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Building Permit Application
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Planning and Development Services St.woe COUn
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pier:e FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
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PERMIT AP?LICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:- .
Address: ger..&-•;‘) /or "
Legal Descripti 3n:
Propertv-Tax ID#: 1301-111-0001-000/5 =2_ e_ Lot No_
Site Plan Name: ' Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
I DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack
CONSTRUCTION INFORMATION:
Addruona wor to .e e orme. unwert is permrt—c ec a ti appy:
THVAC Gas Tank Gas Piping -- Shutters nVVindows/Doors
Eectric I Plumbing [11SprinklersGenerator Roof
Total Sq. Ft of Construction: STILit.of First Floor:
Cost of Zonstrxtion:$ c-5--ec2 OO Utilities:I _Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US#'I Suite 402 Company: Law's Electric, Inc.
City: - Port St Lucie State: FL Address: 218 Beach Avenue
Zip :ode: 34952 Fax: City: Port St. Lucie State: FL
Phone No_ 772-878-5513 Zip Code: 34952 Fax: 772-878-3347
Phone No. 72-971-4512
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 cons:ructiorlis$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: V 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: r/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.
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 Ass` rration 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 recordingyour Notice of Commencement.
ge'V,4/
Sign re of Owner/Agent/Lessee Sig re of Contractor/License Holder
STATE OF FLORIDA QQ STATE OF FLORIDA . -
COUNTY OF ` ; �Gl�� COUNTY OF ai�, �
The fnrFc)ing instrument was a n_o wledged,before me The fornoing instr'!' ntwas ack owledged before me
this.! rrlay of IGsC J L .20/9 by this4 ay
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--:-TfT4n'I () L J frfg1�S LAY.4)
(Name of person acknowledging) (Name of person acknowledging)
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,(Si atur of Notary Public-State of Florida) (Si atu of Notary Public-State of Florida)
Personally Known ✓OR Produced Identification JuiEet Law Personally Known r/ OR Produced Identification
Type of Identification Produced T. "_` i_ TypOe of Identification Produced
� ' STATE OF'FLdRelssion •No_ 6(s0���. ..c 0�' ."" Juliet Law.
Commission No.6 ��4 �-� �_ ,; NOTARY PUBO•
Comm#Gt?046735 STATE OF FLO- A
Expires 1'/13/2020 1.-
• s"TCF a Expires 91/13/2' 0
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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