HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ;
Date: f f �--�P Permit Number: 'i`V
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Building Permit Application E�4coo0A
Planning and Development Services %11��
Building and Code Regulation Division P
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
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PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT,LOCATION:
Address: / "4=J�
Legal Description:
Property Tax ID#: 3414-501-1701-000/9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF`1NORK:
Replace meter center with a combo pack at each address
CONSTRUCTION INFORMATION.
Additional work to (e ne orme under this permit—check a appy:
F]HVAC LJ Gas Tank ❑Gas Piping _Shutters Windows/Doors
QElectric 0 Plumbing Sprinklers F]Generator F]Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$_' � ��__ Utilities:Ei Sewer Septic Building Height:
OWNERAESSEE: CONTRACTOR:.
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US#1 Suite 402 Company: Laws 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:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: Stater
Zip: Phone: .Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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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 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Sigfidture of Owner/Agent/Lessee nature of Contractor/ icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �,�'� COUNTY OF
The forgging instrun t w s ac__k_powledged before me The forgoing instru ent was ^knowledged before me
this 47,day of 201q-by this day of �. 20by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary.
y4State okFlori a) (Sign ture of Nota is-State of Florida)
Personally Known OR Produced Identification Personally Known V OR ProducedIdentification
Type of Identification Produced Type of Identification Produced
t�Rrao 1.1111"
111 yJ.Pmske r Beverly J.PF09ke
Commission No. n NOTARYPUBW Commission, 110TARYPIIBLIC (Seal)
STATE OF FLORID., & -+STATE OF FLORIDA
GG262780
Revised 07/15/2014 Expires 9/26/2022 e,110; Expires 9126/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED