HomeMy WebLinkAboutBuilding Permit Application ALL APPLI BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number: IILO`7• �¢b U
Building Permit Application ' SEP 2 3 2016
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fart Pierce FL 34952
Phone:(772)462-1553 Fax:(772)462-1578 Corr mercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT 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:
DETAILE0.DESCRIPTION OF WORK:
Replace meter center with a combo pack.
I
CONSTRUCTION INFORMATION.
Additional work to e e Orme under is permit—c c a _appy:
❑WindowslDoorsHVAC ED Gas Tank ❑Gas Piping Shutters
Electric 0 Plumbing F-1prinklers Generator Roof
Total Sq. Ft of Construction: Ft.of First Floor:
Cost of Construction:$ • .:T70,O.UCS UtilitiesSewer 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: EL 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-Malt: Phone No. 772-971-4512
Fill in fee simple Title 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 IN ORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: ✓'Not Applicable
Name: Name:
Address: Address:
City_ State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: r/Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is herebyadeto obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to th!issuance of a permit
St.Lucie County makes no representation that is granting a peff itwill authorize the permit holderto build the subject structure
which is in conflict with any applicable Home Owners Associatio rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Homeowners Association a d review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,E doh reby agree that l will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Cod s and St Lucie County Amendments.
The following building permit applications are exemptfrom and argaing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,scree n 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 Comme cement must be recorded and posted on the jobsite
.before the first inspection.If you intend to obtain fin ncing,consult with lender or an attorney before
commencingwork or recordingaur Notice of Com encement.
al'�WAI
Si ure of Owner/Agent/Lessee Si tore of Contractor/Luense Holder
STATE OF FLORIDA STATE OF FLORIDA �J
COUNTY OF COUNTY OFA/j[ �
The forgoing instrument was acknowledgped_before me The forgoing instrument was acknowledged before me
this iiay of 20Z4(,by thissiZaday of c6�p 7" .2621E-by
(Name of person acknowledging) (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
ZJVLIETLAW JULIET LAW
Commission No. Ss'rL6sb NOTARY Pyl B [Commission No.,� 6 96/ NOTARY PUBLIC
STATE OF L RIDA STATE OF FLOM
Comer
Revised 07/15/2014 Ef�frog 18/2016 Expines 10128/20
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW. REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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