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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ln (�
Date: Permit Number: fJ "
Building Permit Application' OCT _3 2016
Planning and DevelopmentServites
Building and Code Regulation Division
2300 Virginia Avenue,Fart Pierce FL 34,482
Phone:(772)462-1553 Fax:(772)462-1578 Commercial 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:
LDETMLED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
CONSTRUCTION INFORMATION:
ttiona war o e e orme under tis permit—check a app y:
HVAC 13 Gas Tank Gas Piping _Shutters Windows Doors
9Electric M Plumbing Sprinklers 1:1Generator El Roof
Total Sq. Ft of Construction: Sq-Ft.of First Floor:
Cost of Construction:$ 1' QQD, �Jr� Utilities:0Sewer OSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US#1 Sulte 402 Company: Law's Electric, Inc.
City: Part St.Lucie State: FL Address: 218 Beach Avenue
Zip Code: 34952 Fax: City: Port St Lucie State: FL
Phone No. 772-87B-5513 Zip Code: 3,052 Fax: 772-878-3347
E-Mail: Phone No. 772-971-4512
Fill in fee simple Title Holder on next page I 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: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: j/Not Applicable BONDING COMPANY: P---Not Applicable
Name: Name:
Address: Address:
City: city;
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDUIT:Application is hereby made to obtain a permit to 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 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 1 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,
accessary structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWN ER: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.
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Signature of Owner/Agent/Lessee Ognature of ContractorA icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �'� COUNTY OF
The forgoing instrument was acknowledged_before me The forgoing instrument was acknowledged before me
this 5 day of 2016"by this day of 20/e--by
(Name of person acknowledging) (Name of person acknowledging)
{signature of Notary Public-State of Florida J (SigrrAu'r'b of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known ✓OR Produced Identification
JULIET U Type of Identification Produced U6UC of Identification Produced 51st JULIET�—
STATE OF TATE OF 71_!?RIDA
IF 9 r FC
Commission No. �"�'e5 '� 9U.� { ���sion No. C<���90
Comm#E 846906 mg ESE ;;G6
Expires 1 /2$12016 t Ex ires 10128=16
Reyised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW. REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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