HomeMy WebLinkAboutBuilding Permit Application I�
ALL APPLICABLE INFO MUST 3E COMPLETED FOR APPLICATION TO BE ACCEPTED �ry
Datc_ IJ ` � � Permit Number: C o ti 7 d
Y
Building Permit Application p@5m,X,�e�®�
({ Building and Code Regulation Division ` SC.
2300 Virginia Avenue,Fort Pien.e FL 34982
Phone: (772)462-1553' Fax: (772)462-3578 Commercial Residential X
PERMIT AP?I ICATION FOR: Electrical
PROPOSED INPROVEMENT LOC TION:•
AddrEss:
Legal Descripti:)n: -
I PropertvTax1D#: '130'-191=0001-000!5 ? Lot No.
Site Plan Mame: Bloch No.
Project:Name:
Setbacks Frant Back-- Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo.pack
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CONSTRUCTION INFORMATION:
-Additional work to be ertormed under tis permit—check all tbBj appy:
0HVAC Gas Tank FISas Piping F Shutters Ll Vilindows/Doors
L�IE3ectric E=i Plumbing Sprinklers E Bene"rator L�1 Roof
Tota':Sq-Ft of Construction: SgFt�.(of First Floor:
Cost of Constr_cticn,.$ _ 00 Utilities:L�I Sewer L Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
J
Narre Wynne Building Corp. Name: JamesVV Law
Address: 80C+0 S US# 1 Suite 402 Company: Law's Electric,Inc_
City. Port St.Lucie State:FL Address: 218 Beach Avenue
Zip Corte: 34052 Fax: City: 'Port St.Lucie State: FL II
Phone r4o. 772-878-5513 Zip Code: 34982 Fax: 772-878-3347
E-Mail: Phone No. 772-971-4592
Fiii in fee simple Title Holder on next page(if different E-Mail: I:awselectCicinc@_aot.com
from the Ownar 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:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: —Not Applicable
Name: Name-
Ad dress: 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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in convict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such,i
structure.Pleaseconsult 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 1 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,walls,signs,screen rooms and accessory uses to another non-residential use
"WARNING TO OWNEZ 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
wrm YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Sig ure 6fdn-er7 Lessee/Contractor as Agent for Owner Si ature of Contractor/License Holder
STATE OF FLORIDA - STATE OF FLORIDA _
COUNTY OF � C �� COUNTY OF
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The for oing instrume t was acknowledged before me The forgoing instrument was acknowledged before me
this y day of 2�by this_day of 2g&:D by
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Name of person making statement. Name of person making statement.
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Personally Known V/ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification !
Produced Produced
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(Signature oJ&STATE ida) (Signature b rl�da)
NY PUBLIC OTARY
CS OF FLORp/� o STATE OF FLORIQA
CommissionBeal) Commissian _ G26278 eal)
ComrA#GG2WED Y
4 res 9!26/2022
REVIEWS FRONT; ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE!
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19
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