HomeMy WebLinkAboutBuilding Permit Application ALL APFLiCAKE.INFO NiJST 3E COMPLETED FOR APPLICATION TO BE ACCEPTED
DatE O P7 X17 Permit Number: Ic e) (�) o3u1
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Building
i.Building Permit Application
Planning and Develop e��Sen�ices o j a
Building and Code Regulation Division GOw�
2300 Virginia Avenue,Fort;:lier:e FL 34982
Phone: (772)462-1553 =ax: (772)462-1578 Commercial Residential
PERiAIT AP ?_ICATION FOR:. Electrical
PROPOSED iNPROVEMENT LOCATION.-
Address:',
Legal DEscripti:)n: a
i Properti Tax ID#: 1301-111-0001-00015 =' (= Lot No.
Site Plan Name: Block No_
Project.game:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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Replace meter center with a combo pack j
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ISTRUCTION INFORMATION:
optionalwork toe- performed under tis permit—c ec a t appy:
HVAC E] Gas Tank F]Gas Piping -_Shutters a Windows/Doors
'- E;ectric F I Plumbing Sprinklers a Generator El Roof
Tota'Sq_ Ft of Construction: 5 _Ft.of First Floor:
Cost of�onstr_ction:$ 00, JCS Utilities:Sewer❑Septic Building Height:
ht:
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OWNER/LESSEE: CONTRACTOR: j
Narre Wynne Building Corp. Name: .lames W Law
Address: 8007 S US#1 Suite 402 Company: Law's Electric, Inc_
City: Port St. Lucie State:FL Address: 218 Beach Avenue
Zip :ode: 34952 Fax: City: Port SL Lucie State:"
tate: FL
Phone No_ 772-878-5513 Zip Code: 34952 Fax: 772-878-3347
E-iVail: Phone N'o. 772-971-4512
Fill in fee simple Title Holder on ne}:t page(if different E-Mail: lawselectricincgaol_com
from the Ownar listed above) State or County License: ER0000122 f
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if value of cons ruction 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: I
Address: Address:
City: State: City: State: f
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 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/UcenseLHolder
STATE OF FLORIDA /z STATE OF FLORIDA
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COUNTY OF ( r[,Cd COUNTY OF
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The forgoing instruillgrityp acknowledged before me The forgoing instryrpentwas acknowledged before me
this/_jday of ,26/ by thisday of � ,�11 20 by
Name of person making statement. Name of person making statement. I
Personally Known OR Produced Identification Personally Known ,,� OR Produced Identification
Type of identification Type of Identification
Produced Produced
(Signature of� (Signatur gt&rida)
STATE OF FLOPSTATE OF FLORIDA
Commission OZB271) Commissi GG262780 (Sea!)
'Mcg 110ree 9126/2022
irxAires 8/26/2022 '
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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.2/7719
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