HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED.FOR APPLICATION TO BE ACCEPTED
Date: -f'L44tL. Permit Number:
A RECEDVED
Building Permit Application' SEP 12 2016
Planning and DevelopmentServices PERMITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34992
Phone:(772)462-1553 Fax:V72)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEIVIENT LOCATION-:'
Address:
Legal Description:
Property Tax ID#: 3414-501-1701-000/9 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:
A&(tfonal work to be ne rmed under this permit-check all thin apply:
E-1HVAC Gas Tank F�Gas Piping FIShutters F Windows/Doors
Electric Plumbing ❑Sprinklers FiGenerator Roof
Total Sq. Ft of Construction: So. Ft.of First Floor:
Cost of Construction:$- -/-- C) UtilitiesSewer Septic Building Height:
:
OWNERAESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address- 8000 8 US 01 Suite 402 Company. Laws Electric, Inc.
City: Port SL Lucie State:.FL Address:. 218 Beach Avenue
Zip Code: 34952 Fax: City:— Port St-Lucie State: FL
Phone No. 772-878-5513 Zip Code:_ 34652 — Fax: 772-878-3347
E-Mail: Phone No_ 772-971-4512 - - -
Fill in fee simple'ritle Holder an 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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S,UPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION:
0ESIGNER/ENGINEER: �Not Applicable MORTGAGE COMPANY: Not Applicable
Dame: Name:
Address: Address:
City: State: City: State:
Zfp: Phone: Zip: Phone:
E SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: ce-Not Applicable
Name: Name:
Address: Address.-
City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVI T:Application is hereby made to obtain a permitto 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 will authorize the permit holder to)guild 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 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 roams 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
beforethe first inspection.If you intend to obtain financing,consult with lender or an attorney before
dommencing work or recordingyour Notice of Commencement_
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Sign re of Owner)Agent)Lessee 5 ure of Contractor/License Holder
STATE OF FLORIDA ,� STATE OF FLORIDA -
COUNTY OF �I -f-�P1.� COUNTY O
The foreaing instrument was acknowledged-before me The forgoing instrument was acknowledged before me
this day of J`�ea g2± .201b by thisL_:�',day of 45ef�t 20,!Yp—¢y
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(Name of person acknowledging) ({Name of person acknowledging�
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I( i atur of Notary Public-State of Florida) (Si to of Notary Public-State of Florida)
Personally Known +-'�OR Produced Identification Personally Known P-� OR Produced Identification
ype of Identification Produced Type of identification Produced
JULIET LAW _41)LIET LAW
Commission No. � L�9�x ZY NOTARY PUB (Commission No. 6 D " TARYPUBLIC
STATE OF FLC IRWA" STATE OF FLORIDA
Revised 07/15/2014 Expires 10!28!2016 Expires 10128!2016
REVIEWS FRONT ZOiNIING SUPERVISOR PLANS VEGETATION SEATURTLE MAINGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
,COMPLETED
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