HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 t
Date:. ,3-pt4- Permit Number:
Building Permit Application OCT 2 ��
Planning and Development Services P E R IJI IT'TI NI G
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34952
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical ."
PROPOSED I.NPROVEM_ENT 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:
DETAILED DESCRIPTION OF WORK.-
Replace
ORK:Replace meter center with a combo pack at each address
CONSTRUCTION INFORMATION:
Additional work toe e orme under t is permit—check a appy:
HVAC Ei Gas Tank ❑Gas PipingShutters []Windows/Doors
EElectric F-1 _Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: S .Ft.of First Floor.
Cost of Construction:$_ r fid, r) Utilities:cnSewer Septic Building Height:
-OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Dame: James W Law
Address: 8000 S US#1 Suite 402 Company: Law's Electric. Inc.
City: Port St Lucie State: PL Address: 218 Beach Avenue
Zip Code: 34952 Fax: City: Port St.Lucie State: FL
Phone No. 772-878-5593 Zip Code: 34952 Fax: 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 -89Z6-699-699 Lti££8L8ZLLMVl d6Z:£0 96 9Z 100
I
SlUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
gESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
tme: Name:
Address: Address:
City: State: City: State:
Tp: Phone: Zip: Phone:
FkE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: ;,--'Not Applicable
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.
licertify that no work or installation has commenced priorto the issuance of a permit
St-Lucie Counttyy 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 vilth the approved plans,the Florida Building Codes and St Lucie County Amendments.
T.6efollowing building permit applications are exemptfrom undergoing a full concurrency review:room additions,
aircessary 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
8eforethe first inspection.If you intend to obtain financing,consult with lender or an attorney before
dommencing work or recordingvour Notice of Commencement.
S9 naffre of Owner/Agent/Lessee Sig re of Contractor/License Halder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
s
The forgoing instr2=.,__2Q
�n�tw,�a.�s a-�knowledged_before me The for&oing instrument was acknowledgtd before me
thisr� day of ., .2D/b by this4'Z_if_-day of 20�a -by
(Name of person acknowledging) (Name of person acknowledging)
(S. afar of Notary Public-State of Florida) (Si ata of Notary Public State of Florida)
Personally Known ✓OR Produced Identification Personally Known ri OR Produced Identification
Type of Identification Produced Type of Identification Produced
try JULIET LAW IET LAW
Commission No. �L �9�Z NOTARY PUB (Commission No. 4 D
STATE OF FL Tom'PUBLIC
STATE OF FLORIDA
law
t Expires 1x128/2016 Expires 10128f2t?15
Revised 07/1512014
I
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
;RECEIVED
DATE
;COMPLETED 7.
Z'd -89ZL-L59-L99 Lt ES9L8ZLLMV� d6Z:s;0 9L 9Z 100