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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I I © �� Date: %f �S���� Permit Num L. +. i'm rM E U V r" Building Permit Applic OCT 2 5 2016 Planning and Development Services Building and Code Regulation Division ;. 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 Commercial Bl(' sl en is X PERMIT APPLICATION FOR: Electrical PROPOSED INPROVEMENT LOCATION:- Address: Legal Description: Property Tax ID#: 1301-111-0001-000/5 =? f. 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: itiona wor to e e orme under tis permit—check a apply: HVAC 13 Gas Tank ❑Gas Piping _Shutters `❑,Windows/Doors LJ Electric 0 Plumbing F ]Sprinklers E Generator LJ Roof Total Sq.Ft of Construction: 5 .Ft.of First Floor: Cost of Construction:$_T O o Utilities"nSewer Eleptic Building Height: OWNERAESSEE: 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 Faye 772-878-3347 E-Mail: Phone No. 772-971-4512 Fill in fee simple Title holder 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. 6'd -892 6-699-699 Lti8E8L8ZLLMVl d89:00 9l, 9Z loo i SUPPLEMENTAL CONSTRUCTION LEEN LAIN INFORMATION: DESIGNER/ENGINEER: .Not Applicable MORTGAGE COMPANY: ;,-"Not Applicable Name: Name- Address: Address: Cty. State: OW-1 State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Nat Applicable BONDING COMPANY: r/NotApplicabie Name: Name- Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIT: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 conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such structure.Please consult w!th your Home owners Association and review your deed for any restrictions which may apply. In consideration ofthe granting of this requested permit,/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. Thefo€lowing 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 commencing work or recordina your Notice of Commencement Lel/ '•' SigWure of Owner/Agent/lessee Si ure of Contractor] icense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The foraoing instr um? t w ac nowledad_before me The forgoing instrument was cknowledged before me thiday of 20_Z 20s _Zyp_by {Name of person acknowledging,) (Name of person acknowledging) I{ a of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced identification Personally Knowny OR Produced Identification Type of Identification Produced Type of Identification Produced MGM JULIET LAWLIET LAW Commission No. 622 66 ,2. NOTARY PUB ICammission No_�t S 6 TARP PUBLIC STATE OF FL STATE OF FLORIDA ftwWUM Revised 07/15/2014 IWIV Expires 10/28/2016 S 10/2812016 i � REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETE€? Z•d -8926-659-699 LtC09L8ZLLMV-I d65:£0 96 9Z 3o0