HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Crate Permit Number: r ��
JUL C;%1019
Building Permit Application
permitting pepartment
Planning and Development Services St Lucre County
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)452-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
9
Address: -
Legal Description:
Property Tax ID# 3427-111-0002-000/5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks. Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
CONSTRUCTION INFORMATION:
Additional Work to be performed un er this permit—c ec a I t=appy:
]HVAC Gas Tank ❑Gas Piping _Shutters t.__1 Windows/Doors
QElectric 0 Plumbing []Sprinklers Generator Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ �+ �� Utilities: Sewer Q 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
Zip Code: 34952 Fax: City: Port St.Lucie State: FL
Phone No, 772-878-5513 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No. 772-9714512
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$2500 or more,a RECORDED Notice of Commencement is required.
1 `
SUPPLEMENTAL CONSTRUCTION LIEN LAW.INFORMATIQN:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: W 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.
St.Lucle 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.
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Wo ature of owner/Lessee/Contractor as Agent for Owner S' ature o Contractor/License Holder
STATE OF FLORIDA r STATE OF FLORIDA I/
COUNTY OF C244'4 . COUNTY OF
The for-oing Instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of _—XC L\,/1 20 by this day of���20 by
Name of person making statement. Name of person making statement.
Personally Known 2�011 Produced Identification Personally Known OR Produced Identification
Type of IdentificationType of Identification
Produced n. Produced
(Signature Of 4 ► - ea) (SignaturesTwo
1MrA ® &rida)
STATE OF FLO �cTATE OF FLORIDA
Commission O2S27�1j Commissi 62780 (Seal)
`►%�G o'► Expires 9/2$/2022 61Eolres 0126/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.2/7/19