HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /,g" Permit Number: 0 - Q3
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Building Permit Application OCT 1 6 2019
Planning and DevelopmentServices
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 CO UXl t�(r FL
Phone:(772)462-1553 Fax: (772)462-1578 Commercial sit ��lf
� PERMIT APPLICATION FOR: Electrical -i_:
PROPOSE JNPROWMENT LOCATION
Address:
Legal Description:
Property Tax ID#: 3414-501-1701-000/9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
[)TAILED D.ESCR!PTION OF WORK
Replace meter center with a combo pack at each address
CONSTRUCTION INF{JRNiAT}ON ILL
Additional work toTe—pertormecl under this permit–check all Mal appy:
(
HVAC i�1 Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
EElectric In Plumbing Sprinklers Q Generator 0 Roof
Total Sq.Ft of Construction: Sq
. of First Floor:
Cost of Construction:$ I- d�C) 0 Utilities: aSeptic Building Height:
a)WNERf 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 Code: 34952 Fax: City: Part St. Lucie State: FL
Phone No. 772-678-5513 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No. 772-971-4512
Fill in fee simple Title 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.
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,wails,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."
Is -*14,- flarx 69 M;V�0001'
Pure of Owner/Lessee/Contractor as Agent for Owner S' ature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF (7/Zt-� COUNTY OF
The forgoing Instrument was acknowledged before me The forgoing instrument was acknowledged before me
this </_day of_( !- 2012 by this_&_day of.,„_(�,��. .20ZZ by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known v� OR Produced identification
Type of Identification Type of Identification
Produced Produced
(Signature of` - �da) (Signature @ �Ionda)
F FLO A=-STATE FLORIDA
Commission STATE OG262780 I) Commissi> 2780 (Seal)
mss'c1 ExAires 912612022 s�hcri� limplfas 9126/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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