HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED d
Date: f—24D/4, Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34952
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED lNPROVEMENT LOCATION
Address:
Legal Description:
PropertyTax ID#: '1301-111-0001-oQ015 _ti L 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 at each address
CONSTRUCTION INFORMATION:
Additional work toe nertormed un ert is permit—check all appy:
HVAC Gas Tank E]Gas PipingOGenerator
Shutters E]Windows/Doors
aElectric Plumbing Sprinklers a Roof
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ /, d UO , 0 Utilities: Sewer 0 Septic 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_
City: Port St.Lucie State. FL Address: 218 Beach Avenue
Zip Code: 34952 Fax: City: Port St. Lucie State: FL
Phone No. 772-878-5513 Tp 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 is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: f/Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TM HOLDER: Not Applicable BONDING COMPANY: v,"Not Applicable
Name: 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 County makes no representation that is granting a permit wilt 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,l 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 exemptfrom undergoing full concurrency review:room additions,
accessory strucWres,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 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.
1
SigdAure of Owner/Agent/Lessee S- tore of Contractor/Vicense Holder
STATE OF FLORIDA // STATE OF FLORIDA
COUNTY OF COUNTY OFQ
The for ing instrument was acknowledged-before me The forgoing instrument was acknowiedged before me
thisday of 20 -by this 6- day of 21) -by
{Name of person admowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signa ure of Notary Public-State of Florida)
Personally Known ✓ OR Produced Identification Personally Known �OR Produced Identification
Type of Identification Produced Type of Identification Produced
S El' LAW JULIET 1.AYY
Commission No. NOTARY PUS.Mommission IVo_r.4c' /69�f_, NOTARYPUBLIC
STATE OF FLORIDA STATE OF FLORI
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Revised 07115/2014 Expires 10128M16 Exprras 1QQ%20
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW. REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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