HomeMy WebLinkAboutBuilding Permit Application ALL APPLICA LE INIFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J r_
Date: C �7 az®/lo Permit Number:
Building Permit Application
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 Residential X
PERMIT APPLICATION FOR: Electrical 0
PROP'OtEEiIN-OitOVEMENT U.CATION::
Address•
Legal Description:
PropertyTax ID#: 1301-111-0001-00015 C Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAI O.l.03.IPTION OFIIOR x b.
Replace meter center with a combo pacle:
CONSTRUCTION I N10.R.IAATtGN"
Additional work to rGas
ormun ert is permit—c ec a app y:
HVAC Tank aGas Piping _Shutters Q Windows Doors 1
Electric ri Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ _5_0 d O Utilities. Sewer Septic Building Height:
0WN AAESSEE: CONTKACTOR:
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
tate: FLPhone No. 772-878-5513 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.
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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:
Zap: Phone: Zip: Phone:
IME SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: ;,-Not Applicable
n ame: Name:
Address: Address:
clhr: 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 granfmg a permit will authorize the permit holder to build the subject structure
v¢hich is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
sspuucture.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
tri 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 a full concurrency review:room additions,
a I 6cessory 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.Jf you intend to obtain financing,consult with lender or an attorney before
commencing work or recording. our Notice of Commencement
Sfgn re of Owner/Agent/Lessee Si re of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �/.f P,t ,rJ COUNTY OF a 7-
The forgoing instru nt was a knowledge¢before me The forgoing instru ent was acknowledged before me
this day of .201b-by this 2 &riay of =A .2U&^by
F 0
(Name of person acknowledging) (Name of person acknowledging)
i
( Iatur of Notary Public-State of Florida) (SihnItulb of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known e-- OR Produced Identification
Type of Identification Produced Type of Identification Produced
tar JULIET LAW ,tli�T LAW
Commission No. G9 NOTARY PUB 1Mommission No.—=,F–S 6 IMSTATEOFFLOR111A
l TARY PUBLIC
STATE OF FL A
4t0EE�plres 10128/2016
Revised 07/15/2014 Expires 10/28P2016
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
),TATE
COMPLETED
Z'd -89ZL-699-699 LV££8L8ZLLMV1 e6Z:01. 96 LZ 100