HomeMy WebLinkAboutBuilding Permit Application ALL APPLI BLE INFO MUST BE COMPLETED FOR APPLICATION TO BEACCEPTED
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Date: Permit Number_
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Building P Application
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Planning and Development Services
Building.and Cade Regulation Division
2300 Virginia Avenue,Fort Pierce FL 349B2
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION.:.
Address
Legal Description:
Property Tax ID#: 1301-111-0009-00015 T( 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
CONSTRUCTION INFORMATION:
Addilionall work to E]GasTank
rme un ert is permit—c ec a appy:
HVAC 013as Piping _Shutters a Windows/Doors
Electric Plumbing Sprinklers 1:1 Generator E]Roof
Tatal Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ Utilities Sewer F1 Septic Building Height:
OWNERf 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: FL 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-Niall: Phone No. 772-979-4512
FII in fee shnple 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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
D.ESiGNERJENGINEI:R: V Not Applicable MORTGAGE COMPANY: ✓Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: t/Not Applicable BONDING COMPANY: c/Not Applicable
Name: Name:
address: Address:
tarty: City:
TJp: Phone: Zip: Phone:
OWNERI CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permitto do the work and installation as indicated.
I certifythat 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 with your Home Owners Association and review your deed for any restrictions which may apply_
Irk consideration of the granting of this requested permit,i do hereby agree that I will,in all respects,perform the work
iq accordance with the approved plans,the Florida Building Codes and St Lucie County Amendments.
The following building permit applications are exemptfrom undergoing a full concurrency review:mom 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
11riprovementsto your property.A Notice cf 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
clm mriencinR work or recording our Notice of Commencement.
Sigoture of Owner/Agent/Lessee Si ure of Contractor/ 'cense Holder
STATE OF FLORIDA p�J ,D STATE OF FLORIDA
COUNTY OF �,ll�`.�fi ,ff_ ,r' COUNTY OF
r
The forgoing rostrum t was atI ow[edggd before me The forgoing instrument was cknowledged before me
thi BY of 20 by thi%0#_-day of 20.
(Name of person acknowledging) (Name of person acknowledging)
( re of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
i
Personally Known AOR Produced Identification Personally Knowny OR Produced Identification
Type of Identification Produced Type of Identification Produced
JULIET LAW ��3l.IET LAW
Commission No. �" rL�Qi, NOTARY PUB �ommissi on No. ,S,S,-_ �« �Db S ,pp
do Comm#EE846106 STATE OF FL A TARY PUBLIC
STATE OF FLORIDA
Revised 07/15/2014 1 Expires 10128/2016
Expires 10/28/2016
REVIEWS FRONT ZON114G SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED •
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