HomeMy WebLinkAboutBuilding Permit Application ALL APPLIC LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: �� _CRL1 to
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BuildingPermit Application %� e�`�
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Planning and Development Services peQo�
Building and Code Regulation Division �e����� G
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (7721'462-1578 Commercial Residential X
PERMIT APPLICATION FOR:' Electrical
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID#: 1306,-111-0001-000/,0 yc�J 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
CONSTRUCTION INFORMATION:
-Add itiona I work to be performed under tispermit—check all appy:
HVAC Gas Tank 0Gas Piping _Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers Generator E] Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities:0 Sewer 11 Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Wynne Building Corp_ Name: James W Law
Address: 8000 S US#1 Suite 402 Company: Law's Electric, Inc.
City= Port State: Address:
St Lucie FL 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. 772-971-4512
Fill in flee 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 N required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: 1 Not Applicable MORTGAGE COMPANY: Not Applicable
Name: I Name:
Address: Address:
City- State: City: —State- I
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable i
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
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Coun 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
I
structure.Please consult with your Home Owners Association and review your deed for any restrilctlions 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,i I
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 roams 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:'
nature of owner/Lessee/Contractor as Agent for Owner Sip&ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA J/ I
COUNTY OF COUNTY OF
The forgoing instrument!)Nas acknowledged before me The forgoing in ru erkt was acknowledged before me
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this 2.Z day 0 20& by this /J-3 day Of Z&g 20& by
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Name of person making statement. Name Of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification 1
Type of Identification Type of Identification
Produced Produced
nature V Owner/Lessee/Contractor
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{Signature77i� oi &Wismg Florida) (Siri—ature c, SlftoWlorlda)
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETE[ i1_7
Rev.2/-RI9