HomeMy WebLinkAboutBuilding Permit Application ALL APPLICA_B E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,n,/�� -•��
Date;_ /f� Permit Number.
Building Permit Application
Planning and Development Services SEP 0 y
9 20'6
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 IMPROVEMENT LOCATION:
Address: - 6 f r
Legal Description:
Property Tax ID#: 1306111-0001-0001.0 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:
Additional work toe neffo-rmed under tis —checkpermit a appy:
HVAC Gas rank ❑Gas Piping _Shutters Q Windows/Doors
EJElectric 0 Plumbing OSprinklers F�Generator Roof
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$_ ��.d Utilities: 0—Sewer 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 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No. 772-9714512
Fill in fee simple Title Holder on next page(if different E-Mail: lawselectdcinc@aol.com
from the Owner listed above) State or County License: ER0000122
If value of construction is$2540 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
1.
DESIGNER/ENGINEER: _Nat Applicable MORTGAGE COMPANY: v"'Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: ciNot Applicable
Nance: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the workand installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Counter makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflictwith any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt-from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencina work or recording our Notice of Commencement.
a,�i vY� r
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Sig$ifure of Owner/Agent/Lessee 5405tuFe of Contractor/license Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF eG�-I'°d COUNTY OF
The foraging instrument was acknowledged,before me The forgoing instrument was acknowledged before me
this.Agtday of 20 ' by this Z&day of �a�7" 20-by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Slgn'alGireW Notary Public-State of Florida)
Personally Known ✓ OR Produced Identification Personally Known A""--OR Produced Identification
Type of Identification Produced Type of Identification Produced
1 LAW JULIET LAW
Commission No. ,�y-s�s�f�� NOTARY PUB IQommission No. d gam! NOTARY PUBLIC
STATE OF FL :IDA STATE OF FLOM
Comm
Explros 10/28/2016 ExpIWs 10128/20
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW. REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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