HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number:
BY
St. Lucie County RECEIVED
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE: Electrical
PROPOSED IMPROVEMENT LOCATION:
Building Permit ApplicaLion 12 ?019ounty, permitting
Commercial x Residential
Address: 4120 SELVITZ ROAD FORT PIERCE FL 34981
PropertyTaxlD #: 2432-233-0001-000-6
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
INSTALL ELECTRIC WIRING FOR DEWATERING FACILITY. 600 AMP 480 VOLT service with a step down transformer to
supply power to existing building. Install electrical for all dewatering equipment, and wiring inside building for high bay fixtures,
lights and outlets.
I CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit— check all that apply:
Mechanical
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 45,000.00
_ Gas Piping
_ Sprinklers
_Shutters —Windows/Doors
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ACCURATE SEPTIC HOLDING LLC
Name: JAMES W LAW
Address:4120 SELVITZ ROAD
Company: LAWS ELECTRIC INC
City: FORT PIERCE State: _
Zip Code: 34981 Fax: 77-489-7778
Phone No.772-489-4411
Address: 218 BEACH AVENUE
City: PORT ST. LUCIE State: FL
Zip Code: 34952 Fax: 772-878-3347
Phone No 772-971-4512
E-Mail: www.accuratesepticservices.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail lawselectricinc@aol.com
State or County License ER 0000122
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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.
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 conflict with any applicable Home Owners Association rules, bylaws or anci 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, 1 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, 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 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_"
' nature of Contracto
Sr/License Holder
.
nature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFSAINT LUCIE
COUNTY OFSAINT LUCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 28 day of AUGUST 20_ by
this xa day of AUGUST 20_ by
JAMES W LAW
JAMES W LAW
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
19
Produced
( ature of u Ic-State of Florida)
BeveryJ.Proske
(Si ure of Nota i - State of Florida )
1�py
Commission No. GG262780
NOTARYPUBLIC
GG262780 t PeverlyJ.Praske
Commission No. �, P(Seel)y PUBLIC
A10
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STATE OF FLORI
4 STATE OF FLORIDA
Comrn# 002827
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