HomeMy WebLinkAboutBuilding Permit Application I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �/
Date: ��-0 Permit Number. �� / �� ! .
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1575 Commercial Residential X
PERMIT APPUCATION FOR: Electrical
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PROPOSED INPROVEMENT LOCATION:
Address: -
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Legal Description:
Property Tax I D#: 3414-501 1701-000/9 Lot No.
Site Plan Name: Block No.
Project Name: 'I
Setbacks Front 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.-pertormed under tfils permit—checK all tbat appy:
MVAC i=f Gas Tank 0Gas Piping _Shutters F Windows/Doors
Electric Plumbing FISprinklers Generator 0- Roof
Total Sq_Ft of Construction: Sq.Ft.of First(Floor: '(
Cost of Construction:$ Utilities Sewer _Septic Building Height: I
" II
OWNER/LESSEE: CONTRACTOR: 1
Name Wynne Building Corp. Name: .lames W Law �l
Address: 8004 S US;# 1 Suite 402 Company: Law's Electric.Inc.
City: Fort St.Lucie State:, FL Address: 218 Beach Avenue l)
Zip Code: X952 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 Titte Homer on next page(if different E-Mail: lawselec:tricinc@aol.com
from the Owner listed above) State or County License: . ERO000122
If value of construction is$?Stip or more,a RECORDED Notice of Commencement is required_
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER EINGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address:— Address: J
City;
State:
State: City.
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 permitto dothe work and installation as indicated.
ftertify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Coun makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with au applicable Home Owners Assoc2 tion 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 agreethat 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,
accessary structures,swimming pools,fences,wells,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 PAYWG
TWICE FOR MWROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED A
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:' II
$nature of Owner/Lessee/Contractor as Agent for Owner— Si Lure of contFactorfLicense Holder
STATE OF FLORIDA STATE OF FLORIDA '7
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Fday of � r,20z3o by this day of 2%&Oby
Law
Name of person making statement. Name of person making statement
Personally Known V"" OR Produced Identification Personally Known 1-1"' OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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(Signature -UblwjSmQf Florida) (51 nature
NOTARY PUBLIG NOTARY PUBLIC
Comm ARIDA(Seal) Commiss FLORIDA (Seal)
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
nature
NOTARY
DATE
COMPLETED
Rev.2/7119
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