HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /�" � Permi
Building !Permit Applic tion JAN 14 2020
Planning and Develoom en t Services Permitting Department
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34.982 St. Lucie COUnty, FL
Phone:(772)462-1553 Fax:(772)462-1578 CommerCia)
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID#: 3414-501-1701-000/9 Lot leo.
Site Plan dame: Black 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:
itiona war to e e orme under=ecK a appy:
QNVAC UGasTank
CGenerator
Shutters Windows/Doors
Electric Plumbing Sprinklers LJ Roof
Total Sq. Ft of Construction: S .Ft of First Floor:
Cost of Construction:$ t�lJ�. l_�el Utilities-nSewer jL lo4SSeptic 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.
C-,ty. Port St.Lucie State. FL Address 218 Beach Avenue
Zip Code: 34952 Fax: City: Port St Lucie State; FL
Phone No. 772-876-5513 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No. 772-971-4512
Fill in fee simple Title Holder on next page I 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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION_
DESIGNERIENGINEER: �Not Applicable MORTGAGE COMPANY: Not Avplieable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _L/Not Applicable BONDING COMPANY_ c-Not Applicable
Name: Name:
Address: Address:
City: city--
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permitto 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,wails,signs,screen roams 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
irslprovements 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 attomey before
commencing work or recordingyour Notice of Commencement. c
Sign re of Owner/Agent/Lessee Sign ure of Contractor//'License Holder
STATE OF FLORIDA �J - STATE OF FLORIDA
COUNTY OF �`�� % COUNTY OF
The for ins:rumPnturas ar nowledge_d efore me Thef❑rgoing instrt- prnwas acJrnowiedged before me
thi%4Zday of 20Ay thi.LZ_Z-day cif.(' !' OjZLby
(Name of person acknowledging) (Name of person acknowledging)
1
( r atur of Notary Public-State of Florida) (S atu of Notary Public-State of Florida)
Personally Known L--`OR Produced Identification Personally Known ;l OR Produced Identification
Type of Identification Produced AMUAt. T pe of Identification Produced
;, IC Juliet Law .
elSTATE OF FLC3 0
Commission No-,rs-cS'b +�- - z y 'ssinn No_ AGO NOTARYPUBLI
o G D4Mi35 - a STATE OF FLRR A
Ires V/13/2020 ii
Revised O7lI512014 - Y S�ftE a . Expires 11113/2 0
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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