HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAB_E INFO MUST 3E COMPLETED FOR APPLICATION TO BE ACCEPTED
Dat . /' Permit Number: V
,rte
-_. Building Permit Application
Planning and Development Services
Building 9nd Code Regulation Division _
2300 Virginia Avenue,.Fort Pier_e FL 34982 j
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERIAIT AP?F ICATION FOR: Electrical
PROPOSED INPROVEMEN LOCATION.-
Address:
OCATION:Address: a
Legal Descripti:)n:
I Properti/Tax ID#: 1301-111-0001-00015 =� [ Lot No_
Site Plan Mame: Block No.
Project-Name:
Setbacks Fro.-it Back: Right Side: Left Side: ,
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack
CO_ STRUCTION INFORMATION:
Additional work to be nertormed under tis permit–check all that apply:
' HVAC L=1 Gas Tank ❑Gas Piping _Shutters a Windows Doors
Sprinklers El Generator Roof
R E"ectric Plumbing
Tota'Sq- Ft of Construction: S�Ftj of First Floor:
Cost of Construction:$ 4/2 00' 00 Utilities- I—Sewe,r aseptic . Building Height:
OWN ER/LESSEE: CONTRACTOR:
Narre 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 Zode: 34952 Fax: City: Port St_Lucie State:. FL
Phone No_ 772-878-5513 Zip Code: 34952 Fax: 772-878-3347
E-IV ail: Phone No_ 772-971-4512
Fill in fee simple Title Holder on next page(if different E-Mail: lawselectdbinc@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_
S.UPPI:EMENTAL CONSTRUCTION`LIEN LAW INFORMATION �
DESIGNER/ENGINEER: Nat 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: Not Applicable
Name: Name:
Address: Address-
City:
ddressCity: 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 certlfy 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
Ili 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."
ature of owner/Lessee/Contractor as Agent for Owner S' ature o Contractor/license Holder
STATE OF FLORIDA {�, STATE OF FLORIDA
COUNTY OF .1 COUNTY OF
The forgoing instrument was acknowledged before me The for g instry ent,was acknowledged before me
this day of ,2%� by this ay of J 20�by
-�-,---. t ter, j. �
JI'm
�'c; �i ��✓.ill c^ ��JJ!� 0 L.
Name of person making statement. Name of person making statement.
Personally Known I',,---OR Produced Identification Personally Known ,,� OR Produced Identification
Type of Identification Type of identification
Produced Produced
i
(Signature a (Signatur Ida) !
_STATE OF FLORiDA
G82
Commission STATE OF 262FLO I) Commissi (Seal)
7 0 -�n�ii�62780
s�ticfi Expires 8126/2022 s�yea?1 ►� EIlplres 8126/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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