HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: o2f91 Permit Num e
9
i� LF
� : OCT 16 2019
Building Permit Applicatio
Planning 6ndDeyelopmentServices Permitting Department
Building and.CodeRegulation Division St. Lucie County, FL
2300 Virginia Aue ue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical a
PROPOSEb INPROVEMENT LO ATION:
Address: /.
Legal Description:
Propertv Tax ID#• 1306111-0001-0001.0 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
CONSTRUCTION INFORMATION:
Acicittionalwortoein3ertormecIunder tis permit—check all appy:
HVAC Gas Tank []Gas Piping _Shutters Windows/Doors
Electric Plumbing Sprinklers F]Generator ❑ Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ UCS. C� r utilities:]Sewer Septic Building Height:
OWN ER/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: 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(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 CAW INFORMATION:
DESIGNERIENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address: k
City: State: City: State:
Zip: Phone: Tip: Phone:
FEE SIMPLE TITLE HOLDf~R: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Tip Phone: Zip: Phone:
OWNERI CONTRACTOR AFFIDVIT:.Application is hereby made to obtain a permltto do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit
St.Luse Count�yy makes no representation that is granting a permit wi"11 authorize the permit holder to bu#!d the subject stretctum
which is m conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict ar prohibit such
structure.Pie consult vuith 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 pians,the Florida Building Codes and St.Lucie County Amendments.
Thefollbwing 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 jobsite
before the first inspection.If you intend to obtain financing,consult with lender or an attorney before
commencing work or recordiriftyour Notice of Commencement.
5 store of Owner/Agent/Lessee fgnature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF .1-UCIE COUNTY OF . I.UCIE
The forgoing instrument was acknowledged before me The forgoing intro nt was acknowledged before me
this ✓?Jday ofy ,26 9by this !'7day of
JAMES W LAW JAMES W LAIN
{Name of person adm doing) (Name of per ledging)
{Sign f Notary Public-State'of Florida} , (Signa of ootary Public-state of Florida}
Personally Known_ 4/1� OR Produced Identification Personal!y Known ✓ 'OR Produced Identification
Type of Identification Produced . Type of Identification Produced
Juliet Law
t Law
Commission No. b (S.101%NOTARY P EOL11mission No. r.q�J&�� CARY PUBLIC
STATE OF LLORIPA STATE OF FLORIgA
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Revised 07115{201.4 Exp#res it/1312020Expirei;
Exp#res 11113! 0220�`:
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE -
RECEIVED
DATE
COMPLETED