HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c�
Date; Permit Number.
ti s
Building.Permit Application
Planning and DevelopmentServices
Building and Code Regulation Division
2300 Virginia Avenge,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1579 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INP OVEMENT LOCATIO -,-
Address:
Address: .5-- ..
Legal Description:
Property Tax ID#: 1301-111-0001-ODO15 -?a Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: RightSide: Left Side:
DETAILED DESCRIPTION OF WORK:.
Replace meter center with a combo pack
CONSTRUCTION INFORMATION:
itiona wor to e e orme under tispermit—check all t=appy:
OHVAC Gas Tante Gas Piping _Shutters Windows/Doors
Electric Plumbing Sprinklers 1 Generator Roof
Total Sq.Ft of Construction: SQ_Ft.of First Floor:
Cost of Co nstructio n:$ .�d0• CSD utilities:0Sewer 0Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US#1 Suite 402 Company: Laws 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 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No. 772-971-4612
Fill in fee simpleTitle Bolder 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 LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: s7Not Applicable
Name: Name;
Address: Address:
Clty: State: City-, State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: I/Nat Applicable BONDING COMPANY: ;.,'Not Applicable
Name: Name.
Address: 'Address:
City: City:
Tip: Phone: Zip: Phone:
OWNER)CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permitto do the work and installation as indicated.
I certify that no work or installation has commenced priorto the issuance of a permit
St Lucie County makes no representation that is granting a permit will authorize the permit holderto 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 afthe granting of this requested permit,i 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 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.
Sigripgra of Owner/Agent/Lessee Sigr
yffure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF .fJ -/��' �� COUNTY OF -The forgoing instrument was acknowledged-before me The forgoing instrument was acknowledged before me
this -5-day of Jew-' 20/b by this f day of E!f f 20��by
nAln
(Name of person acknowledging) {Name of person acknowledging)
i
{S atur of Notary Public-State of Florida) {Si atu of Notary Public-State of Florida)
Personally Known &-" OR Produced Identification Personally Known f/ OR Produced Identification
Type of Identification Produced Type of identification Produced
tl JULIET LAW ET LAW
Commission No. NOTARY PUB mmission No., F 8Sl6 �4b TARY PUeLIG
STATE OF FL A STATE OF FLORIDA
Fires 901262016 Expires 10/2812016
Revised 07/15/2014
I
I REVIEWS FRONT ZOMNG SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEWREVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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