HomeMy WebLinkAboutBuilding Permit Application ALL APFLIC_A -E_INFO MUST 3E COMPLETED FOR APPLICATION TO BE ACCEPTED Q r
DatE•:- _ 7 Permit Number: Q 1
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Building Permit Application
Planning and PevelopmentSenfices
Bui/ ing and Cade Regulation Division
2300 Virginia Avenue, Fort;Mer=e FL 34982
Phone: (772)462-1553 =ax: (772)462-1578 Commercial Residential X
PERIAITAP`'_ICATION FOR: Electrical
PROPOSED IIVPROVEMENT LOCATION-.-
Address:
OCATION:Address: z (lam
Legal Descripti)n:
I PropeMi Tax ID#: 1301-111-0001-000/5 L Lot No_
Site Plan P_'ame: Block No.
Proje=t Name:
Setbacks Fro:it Back: Right Side: Left Side: ,
DETAILED C�ESCRIPTIOfd OF VVORK:
Replace meter center with a combo pack
LCOI`aSTRUCTIOPd INFORMATION:
Additional wor to (eperformedunder tis permit—check all that appy:
E1HVAC L=1 Gas Tank []Gas Piping I _Shutters aWindows/Doors
Vl Ejectric Plumbing Sprinklers F]Generator Roof.
Tota':Sq_Ft of Construction: S�Ft.{of First Floor:
Cost of Constr_ction:$ 400 0O Utilities: I ,-Sewer aSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: dames 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 --ode: 34952 Fax: City: Port St_ Lucie State: FL
Phone No_ 772-878-5513 Zip Code: 34952 Fax: 772-878-3347
E-[Vail: Phone No. 772=971-4512
Fill in fee simple Title Holder on ne}:t page(if different E-Mail: lawselectricinc@aol_com
from the ownar listed above) State or,County License: ER0000122" r
c,
if value of cons':ruction is$2500 or more,a RECORDED Notice of Commencement is required.
i
� - 6
-SUPPLEMENTAL CONSTRUCTION.LIEN AAW, INFORMATION.:
DESIGNER/ENGINEER: _+ Not 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: 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 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 Horne 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 twill,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."
A�__ Ae---- 11 a
ature of Owner/Lessee/Contractor as Agent for Owner S` ature bf Contractor/License Holder
STATE OF FLORIDA a STATE OF FLORIDA
COUNTY OF� COUNTY OF
The forgoing instru _ int was acknowledged before me The forgoing instriiMentwas acknowledged before me
this day of - _ ,20/ by this day of t��--— 20/ 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
(Signature Of a) (Signatur rida)
F Fi.O� STATE OF FLORIDA
STATE O
Corn ission t32t3O !) Commissi– - 7130 (Seal)
{9 Expires 9/28/2022 CHs§ PacplYet3 9/+2812022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.2/7/19