HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO.MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Building Permit Application AUG 2 4 2016
Planning and Development Services PERMITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone:(772)462-1553. Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical El
PROPOSED IMPROVEMENT LOCATION:
Address: � d
Legal Description:
Property Tax I # 1306*111-0001-0001e Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK,!..',.
Replace meter center with a combo pack.
CONSTRUCTION INFORMATION:
it ona war to bene orme under this permit—c ec a appy:
QHVAC LJ Gas Tank Gas Piping _Shutters a Windows/Doors
ZElectric 0 Plumbing Sprinklers F-Generator a Roof
Total Sq.Ft of Construction: SneweroSeptic
f First Floor:
Cost of Construction:$ ��,Q C� UtilitiesBuilding Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address-_ 8000 S US#1 Suite 402 Company: Law's Electric, Ina
City Port SL Lucie State: FL Address: 2'18 Beach Avenue
Zip Code: 34952 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 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$2500 or more,a RECORDED Notice of Commencement it required.
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SUPPLEMENTAL CONSTRUCnON LIEN LAW INFORMATION:
DESIGNER/ENGINEER: iitlotApplicable MORTGAGE COMPANY: 1/NotApplicable
Name: Name:
Adddress: Address: j
City: State: City: State-
Zfp: Phone: Zip: Phone:
FEE SIMPLE TITTLE HOLDER: I/Not Applicable BONDING COMPANY: ;,-Wot Applicable
Name: Name:'
Address: Address:
City: City:
Zip: Phone: zip: Phone:
OWNER/CONTRACTOR AFFIDVM Application is hereby made to obtain a permitto do the work and installation as indicated.
licertifythatno work or installation has commenced prior to the issuance of a permit
St Lucie Co makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which Es in County
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.
IA consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
iii 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,
accessory structures,swimming pools,fences,wails,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 ttierice for
iinprovernents 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 recording our Notice of Commencement.
I
Sig re of Owner/Agent/Lessee 511 ure of Contractor/License holder
i
5t'ATE OF FLORIDA STATE OF FLORIDA -
COUNTY OF .Gf.F r COUNTY OF o /!
The forgoing instrument was acknowledged_before me Theforgoing instrumen was aclmowledged before me
this-Z-3day of 201b by thiszE_day of 7 20 Eby
(Name of person' acknowledging) (Name of person acknowledging)
;:(SJiqr5-tur-Lfof Notary Public State of Florida) (stgffa-tulb of Notary Public State of Florida)
Personally Known OR Produced Identification Personally Known r/ OR Produced identification
Type of Identification Produced Type of Identification Produced
JULIET LAW IE r LAW
Commission No. NOTARY PUBI IMdrnmission No.FF A �D� S r TARP PUBLIC
STATE OF.FL STATE OF FIARIIIA
t Expires 10/28!20116 ,
Revised 07/15/2014 Expires 10/2812016
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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