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Building Permit Application
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �� J r� Permit Number:, -. RECEIVED Building Permit Application MAR /7 2017 Planning and DevelopmentServiceS aurlding and Code Regulagan Division 2300 Virginla Avenue,Fort Plerce FL 34982 Phone:(772)452-1553 Fax:(7721462-1578 Commercial Residential X PERMIT APPLICATION FOR: Electrical 0 PROPOSED INPROVEMENT LOCATION:- Address: Legal Description: Propert%tTax ID#: "1301-111-0001-ODOI5 =?L Lot No. Site Plan dame: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Replace meter cenferwith a combo pack CONSTRUCTION INFORMATION' Additional wor oonGasTank orme undert tspermit—c e a appy-- QHVAC E]GasPiping Shutters aWindows/Doors Electric Q Plumbing OSprinklers L Generator 13 Roof Total Sq_Ft of Construction: Sr _Ft.of First Floor. Cost of onstruction:$ J��,0, 00 Utilities- Sewer Septic Building Heigh OWNER/LESSEE: CONTRACTOR: Name Wynne Building Corp. Name: Dames W Law Address. 8000 S US#1 Suite 402 Company: Law's Electric, Inc_ Port St.Lucie She: PL Address.• 218 Beach Avenue Zip Code: 34952 Fax: City; Port St Lucie State: PL Phone No_ 772-87&5513 Zip Code: 34952 Fax. 772-878-3347 E-Mail: Phone No- 772-971-4512 Oill in fee simple Title Holder an next page{if different E-Mail: lawseleclricinc@aol.com flrom the Owner listed above) State or County License: ER0000122 Itvalue of construction is$250D or more,a RECORDED Notice of Commencement is required. E'd -89Z6-1.59-699 LVSS9L9ZLLMVl dl-0:Z6 Ll, 90 aeW SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER; ,/ Not Applicable MORTGAGE COMPANY: ✓ Not Applicable Name• Name: Address: Address. Ctty: State: City: State: 4p: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: ,Not Applicable Name: Name: Address' Address: (;I' Ity: City: Zip: Phone: Zip: Phone: I cem*that no work or installation has commenced.prior to the issuance of a permit. W Looe County makes no representation that is granting a permitvall authorize the permit holder to build the subjectstructure ��re.Pl��o s itvurt VourrbHomeOwners�ociatiioAsgodn and revliWyouurws deed dforany covenants Which may restrict such In consideration afthegrantIng ofthis requested permit;,i do hereby agreethat I w['ll,in all respects,perforin the work in accordance with the approved plans,the Florida Building Codes and St Lode County Amendments. the following building permit applications are exempt from undergoing a full concurrency review:room additions, accessory structures,swimming pools,fences,walls,signs,screen roams and accessory uses to another non-residential use WARNING TO OWNER:Your failure to Record a Novice of Commencement may result in your paying twice for iltiprovements to your property.A Notice of Commencement must be recorded and posted on the jobsite before thefirst inspection.If you Intend to obtain financing,consult with lender or an attorney before commencing work or recording our Notice of Commencement. f -AV Xe S' tore of Owner/Agent/Lessee 06iature of Contract"11.1cense,Holder STATE OF FLORIDA = STATE OF FLORIDA FOUNTY-OF SAINT WCIE couNTY t}F SAINT LUCIE__. iThefb oingin t as ackn ledged before me Theforgoing instru entwas adm ledged before me !this,.; , ay of 20 Eby thi day of 201`?:by JAMES W LAW LAMES W LAW ( e of person acknowledging) (Nn of person admowledging) &A, YV` CL c (Signature of Notary Public State of Florida) ( attire of Notary Public-State of Florida) I Personally Known ✓ OR Produced ide lAcation Personally Known s/ OR Produced Identification ype of Identification Praduced Type of Identification Produced ommission No. commission Na .� �v� Sea!) ; '"•` , ANNE BRO WALMACH ' .- N#Ft"884663 MY COMMISSION F[arkaN oom r•.4. • # FF966s3 0• ©wIRE&ApRevised 07/15/2014 0121,20 EXPIRES r4prt121.2020 i REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW (DATE COMPLETE 1NFTIALS ti'd -8921-699-699 Lti£E8L8ZLLM1V9 dLC:ZL LL 90 aeA