HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
N 10 .
0219
Date: Permit Number:
I 1"5111
Building Permit Application
Planning and Development Services
Building and 6ade 0gqlation Division
2300 Virginia Aye �, . '6rt Pierce FL 34-982
�
Phone:(772)'46-2 fSS3 Fax:(772)462-1578 Commercial Residential X
PERMIT APPI��ATfit`)N FOR: Electrical
PROPOSED INPRO19EMENT LOCATION:
Address:
Legal Description'::
34147501-1701-000/9
Property Tax I D#: 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 pack.,A�_ _/)
CONSTRUCTION INFORMATION:
Additional wor to be nertormed un er this permit—checK all t=apply:
F1
-las Piping Shutters
HVAC Gas Tank F Windows/Doors
Electric 0 Plumbing E]Sprinklers F]Generator F] Roof
Total Sq-Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ lef9w, D e), Utilities:0 SewerF ]Septic Building Height:
OWNER/LESSEE: CONTRACTOR
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US#I Suite 402 Company: Law's 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: 34652 — Fax: 772-878-3347
E-Mail: Phone No. 772-971-4512
Fill in fee simplelitle 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.
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 thepermit 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 exemptfrom 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 bf Contractor/License Holder
STATE OF FLORIDA I/ STATE OF FLORIDA
COUNTY OF COUNTY OF
y
The forgoing instrum is was acknowledged before me The forg=oing instrum t w s acknowledged before me
this_° day of 20,� by this-4r—day of 20_1,411�' by
Name of person making statement. Name of person making statement.
Personally Known d�OR Produced Identification Personally Known OR Produced identification
Type of identification Type of identification
Produced Produced•
(Signature of i - eY� da) (Signature �jo �4orida)
STATE OF Fl.O o STATE OF FLORIDA
Commission�o G26278a I) Commissiwk e� X62780 (Seal)
I' 8 Expires 91261 022 �hs61�� 11011`06 9156/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Vev-7277719