HomeMy WebLinkAboutBuilding Permit Application ALL APPLIC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: M Jf� Permit Number: Iq q , 614i
RECEIVED
Building
- Building Permit Application
Planning and Development Services SEP 19 2019
Building and Code Agulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address: - Z.
Legal Description: -
Property Tax 1D#: 3414-501-1701-000/9 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 pacts
CONSTRUCTION INFORMATION:
Aitiona workto bene orme under this permit—check a appy:
(j HVAC f�I Gas Tank F]Gas Piping ``_Shutters ❑Windows/Doors
QElectric �Plumbing OSprinkiers []Generator Roof
Total Sq.Ft of Construction: S�Ft.(of First Floor:
Cost of Construction:$l eC7' oe Utilities:L�ISewer Septic Building Height:
OWNER/LESSEE: 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 Cade: 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 4 if different E-Mail: tawselectricinc@aol.com
from the Owner listed above) State or County License: ER0000122
if value of construction is$2900 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW 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.
1 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:"
? Al__ -
ature of Owner/Lessee/Contractor as Agent for Owner S' ature-of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA,,,
COUNTY OF COUNTY OF
Thefor oing instrument was acknowledged before me The for oing instrument was a knowledged before me
this&-day of 2oZE by this& day of 1 20_1�?by
��—lI7 ` k e—S GAJ LA-i c�
Name of person making statement. Name of person making statement.
Personally Known tOR Produced Identification Personally Known v-*"' OR Produced Identification
Type of Identification Type of Identification
Produced Produced
Z dw/Z/4/. .k. - ILI
(Signature of i - �da) (Signature SLFIorida)
4r STATE OF FLOR ]� �c STATE OF FLORIDA
commission 626271�a1) Commissi 'N 1�� 62780 Seal)
ComnVGNCE 19 Expires 9/26/208022 c€ie Expire$9/26/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.2/7/19