HomeMy WebLinkAboutBuilding Permit Application .ALL APPLICABLE INFO
FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date- –=?Z&47 Permit Number -0
K-sm RECEIVED,
Building Permit Application' FEB f 0 2017
Planning and Devel,00ment Services
Building and Code Regulattan Dhdsian
2300 Virginia Avenue,Part Pierce FL 34982
Phone:(772)4624553 Fax:(772)462-I578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID#: 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 packd--/--e,-,,"
CONSTRUCTION INFORMATION:
Additionalwo–rktobe ertormed undirtnis permit–check all app y:
HVAC Gas Tank 0Gas Piping EnShutters Window' s/Doors
Electric F7 Plumbing []Sprinklers E]Generator Roof
Total Sq.Ft of Col I truction: So-Ft.of First Floor:
Cost of Construction.-$ F�
Utilities- Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name�_ Wynn!Building Corp- Name: James W Law
Address: 8000 S US#I Suite 402 Company: Law's Electric, Inc.
City: Port St Lucie State: FL Address: 218 Beach Avenue
Zip Code: 34962 Fax: City. Port St.Lucie State. FL
Phone No. 772-,'878-5513
Zip Code: 3*952 Fax: 772-878-3347
E-Mail: Phone No. 772-971-4512
Fill in fee simplelTitle Halder on next page(if different E-Mail: lawselectricinc@aol.com
from the Owner listed above) State or County License: ER000012-2
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: s! Not Applicable MORTGAGE COMPANY: ✓ Not Applicable
Name: Name:
Address: Address:
City: I State: City: State:
Zip: I Phone: Zip., Phone-
FEE SIMPLE TITLE HOLDER: V Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address-
City:'
ddressCity:' City:
Zip: i Phone: Zip: Phone:
I certify that no work or installation has eommeneed.prior to the issuance of a permit
St.Lucie Courtly makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in canflict With ann"pplicable Home Owners Association rules,bylaws or and Tenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions whlch may apply.
In consideration ofthe granting of this requested permit,l do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Bw'lding Codes and St:Lucie County Amendments.
The following building permit applications are exemptfrom undergoing a full concurrency review.room additions,
accessory structures.swimming pools,fences,walls,sus,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 Wce 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 recordinavour Notice of Commencement.
Si re of Owner/Agent/Lessee 5 re of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
'COUNTY OF I SAINT WCIE COUNTY OF SAINT WCIfE..
I
Theforgoing instrument was acknowledged before me The foreoing instrumentwas acknowledged before me
this day of �L _, 20,Zby this jMday of 2GZ2 by
JAMES W LAW JAMES W LAW
(Name of person admowledging) (!Name of person adcnowledging}'
W �it�C� YAC V V
( nature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida
Personally Known! OR Produced Idenefication Personally Known k�OR Produced Identification
Type of identification Produced Type of Identification Produced
.Commission No. 7 - lO (Seal) Commission No. Seal)
• "•"Y9 ANNE BROWN.wAl ' S"''
NNE
My CCMMf9310N a FF884fi63 �+' ''' M'Com MISSION I FF984883
Revised 0711512014 EXPIRES April 21:2020 EXPIRES April 21,2020
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ItEVl1=1Af3 FRONT ZONING SIiPERVISOR PIANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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