HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: 1,3_ ,�/fv Permit Number: I
RECEDIfE
Building Permit Application' OCT 17 2016
Planning and Development Services PERN1I77ING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical 0
PROPOSED INPROVEMENT LOCATION:
Address: ' S
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:
lona wor to [e'ne orme under is perms —check a appy:
HVAC L_J Gas Tank
—]Gas Piping _Shutters a Windows/Doors
P1Electric 1:1 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SQ. Ft.of First Floor:
Cost of Construction:$ ., ad Utilities: oSewerEl Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address: B000 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: PL
Phone No. 772-878-5513 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No. 772-971-4512
Fill in fee simpleliitle Holder on next page(if different E-Mail: Iawseiectricinc@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: „1/Not Applicable BONDING COMPANY: "ot Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permitto do the work and installation as indicated.
I certify that no work or installation has commenced1priorto 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 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 exemptfrom undergoing afull 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
commencing work or recording our Notice of Commencement.
aell.-JIlAl �Zw
nature of Owner/Agent/Lessee gnature of Contractor/License Halder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF �r
The for Ding instru nt was acknowledged.before me The forgoing instru ent was acknowledged before me
this day of 2_e by this/, _day of 2D,f�by
(Name of person acknowledging) (Name of person acknowledging)
(S3griature of Notary Public--State of Fiorida) (Siu_rb of Notary Public-State of Florida)
Personally Known `� OR Produced Identification Personally Known ✓OR Produced Identification
Type of Identification ProducedFU LiapC of Identification Produced Zlx JUUET 1QC
STATE OFF % TATE OF�!_�RIDA
Commission No.•��6,�� �U.b ( ��ssion No_�,��fL�9y
Comm#E 846906 rn#
W_ _ Expires 1 /2812016 Ex fres 10/282016
Revised 07115/2014
REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW. REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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