HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPT
Date: 'a 4gon Q PermitL�ermitting
RE
Building Permit ApplicaJAN 14 2020
Planning and Development Services OeBuilding and Code Regulation Division LUCK' i�artCpent
2300 Virginia Avenue,Fort Pierce FL 34982 COun
n � FL
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residentla
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address: 54-
Legal Description: -
Property Tax ID#: 3414-501-1701-000/9 Lot No.
Site Plant Na me: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
CONSTRUCTION INFORMATION:
AdElitional work toe nerformect un er t is permit—check a appy:
aHVAC0 Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
RElectric 1:1 Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: So.Ft.of First Floor:
Cost of Construction:$_ CJd. CDcy Utilities: Septic Building Height:
OWN ERILESSEE: 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. LucieFL
State;
Phone No. 772-676-5513 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$2sao or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: v'Not.Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: j/Not Applicable BONDING COMPANY: i/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 priorto 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,l do hereby agree that 1 will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St Lucie County Amendments.
Thefollowing building permit applications are exempt from undergoing a full concurrency review:room additions;
accessorystructures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Yourfailure 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 recordingyour Notice of Commencement.
f /"/ /
aAw
Sign re of Owner/Agent/Lessee Sig (dure of Contractor/License Holder
STATE OF FLORIDA //�� - f STATE OF FLORIDA
COUNTY OF ,. `� .U. � COUNTY OF
The forgoing instrument was acknowledged before me The foraoing 4nstri Pnt was acpPowl edged before me
this;.�day of i do 20.=Lby thiz��ay Of Eby
(Name of person acknowledging) (Name of person acknowledging)
{5� atur of Notary Public-State of Florida) (Sr atu of Notary Public-State of Florida)
Personally Known 4,-�OR Produced identification Personally Knowny OR Produced Identification
Type of Identification Produced t r 10r6r[ w Type of Identification Produced
eIC Juliet L36v
Commission No. �`d °` STATE OF L(5R (Msion No. GC O 1NOTARY PUBU
GC 046735 - STl�TE 01=FLQRIM
E= €res 1 113/2020
eenv"#em
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Revised 47/1512014 v r''� � E,:.yVMS 1111312 0
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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