HomeMy WebLinkAboutBuilding Permit Application All APPLICAB E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r�
Dat /r� Permit Number: lf1 v V�0 0
- RECEIVE®
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Building Permit Application SEP 1 3 2016
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue,Fon Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical El
PROPOSEb INPROlVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID#: 113046-1111-0001-000iz9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WOR}4...' .".
Replace meter center with a combo pack
CONSTRUCTION INFORMATION:
Additional work to nGasTank
orme un er is permit—c ec a appy:
HVAC ❑Gas Piping _Shutters E,Windows/Doors
FElectric 0 Plumbing Sprinklers 1:1 Generator Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ .,���d d Utilities:Sewer FSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: .lames W Law
Address. 8000 S US#f 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 Zip Code: 34552 Fax: 772-878-3347
E-Mail: Phone No. 772-971-4512
Fill in fee simple Title Holder on next page(if different E-Mail: lawselectric1nc@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: _Nat Applicable MORTGAGE COMPANY: Not Applicable
tame: Name:
Address: Address:
City: State: C'rry: State:
Zip: Phone: Zip: Phone:
FEESIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: ;,-Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFID111T:Application is hereby made to obtain a permitto clothe work and installation as indicated.
I jcertify that no work or installation has commenced prior to the issuance of a permit.
St Lucie County makes no representation that is granting apermit will authorize the permit holder to build the subject structure
*hich is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
ssttrruucture.Please consult with your}come Owners Association and review your deed for any restrictions which may apply.
Irl consideration of the granting of this requested permit,I do hereby agree that l will,in a]I respects,perform the work
rri 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 pasted on the jobsite
before the first inspection. if you intend to obtain financing,consult with lender or an attomey before
commencing work or recordin our Notice of Commencement.
i
Si ure of Owner/Agent/Lessee Si re of Contractor/ 'cense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ) COUNTY OF
The forgoing instrument was acknowledged-before me The foreoing instrument was acknowledged before me
this day of S:L,0jQ f 20 this day of f 020.
�by
(!Name of person acknowiedging) (Name of person acknowledging)
( aitlure of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known &---'OR Produced Identification Personally Known e-- OR Produced Identification
Type of Identification Produced Type of Identification Produced
y JULIET LAW IET LAW
Commission No. �,.c ��9r�2 NOTARY PU la ommission No.F F�6�Ob TARY PUBLIC
STATE OF FLORIDASTATE OF FLORIDA
Revised 071L5/20l4 qR
t Expires 10128/2016 Expkes 10/28=16
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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