HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application 0%101
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Planning and Development Services evalX'mec�
Building and Code Regulation Division � ��CJ.
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2300 Virginia Avenue,Fort Pierce FL 3!982 5 '
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Phone: (772)462-1553 Fax: (772j462-1578 Commercial Residential X
PERMIT APPLICATION FOR t Electrical
PROPOSE@ INPROVEMENT LOCATION:
Address: 15*1
-t� -
Legal Description:
Property Tax ID#: 13016111-0001-00010 yC�'2 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:
Additional work to be nprtormed under tis permit—check all appy:
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HVAC _Gas Tank ❑Gas Piping lShuters a Windows/Doors
Electric F] Plumbing Sprinklers enerator 0 Roof
Total Sq. Ft of Construction: SFt,of First Floor: j
Cost of Construction:$ _, U ['� Utilities:�Sewer Septic Building Height:
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OWNERAESSEE: 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. 772-971-4512
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 construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: i
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: __.. Name:
Address- Address:
City: State: City: state•
Zip: Phone Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDIAT: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 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 1 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 acIditlons,
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
WffH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.?'
nature of Owner/Lessee/Contractor as Agent for Owner Si tune of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA r �
I,I COUNTY OF, COUNTY OF_ = f
The forgoing ilnstrumept was acknowledged before me The forgoing instrument was acknowledged before me j
this Z day of w J 20� by this�day of g� '� 20_Z!?by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of identification Type of Identification
Produced Produced
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(Signature arIvu
11 SM g Florida) (Signature a y9il lorlda)
NOTARY PUBLIC 4 NOTARYPUBLIC
CommiRIDA (Seal) Commiss (Seal)
Comm#GG262760 w Comm#GG26 Rau
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
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