HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number.
R:E C E I V7 D MAR 31 2017
Building 'Permit Application'
Planning and Develpfimekt.Services
Bullcring and Code Regulatidn Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax*.(772)462-1578 qommercial Residential X
PERMIT APPLICATION FOR: Electrical
iPROPOSED INPROVEMENT LOCATION:
Address:
4-
Legal Description:
Oroperty Tax ID#: 3414-501-1701-OW/9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front_ Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
I
Replace meter center with a combo pack at each address
CONSTRUCTION INFORMATION:
A,qatbonal woric to be rmed under thlb pMlmlt- ecX all that apply:
i . I Shutters E
HVAC 7Gas Piping
Gas Tank Windows/Doors
Electric Plumbing 7Sprinklers 0 Generator CRoof
Tbtal Sq.Ft of Construction: SCI.Ft.of First Floor
Cost of Construction: Utilities:USewers
1eptic Building Height:3
-OWNER/LESSEE: CONTRACTOR:
N�me Wynne Building Corp. Name: James W Law
Address: 8000 S US 1 Suite 402 Company: Law's Electric, Inc.
City FL
Port SL Lucie State. Address: 218 Beach Avenue
�p*Code: 34952 Fax: CJtv: Port St Lucie state.• FL
Phone Na. 772-878-6513
Zip Code.• 34952 Fax: 772-878-3347
Elimall: Phone No. 772-971-4612
Fill in fee simplelitle Holder on next page(if different E-Mail: laweelectricinc@aol.com
4m the Owner listed above) State or County License: ER0000122
lhooalueof construction Is$2500 or more,a RECORDED Notice of 160—imnencement is required.
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S#JPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION:
D; SIGNER/ENGINEER: V 111otApp11cable MORTGAGE COMPANY: k-lNot Applicable
Name: Name:
Andress: Address:
Cly: State: City: State:
Phone: Zip: Phone-
l]
FSE SIMPLE TITLE HOLDER Not Applicable BONDING COMPANY: r/Not Applicable
me. Name-
Address: Address:
C City:
Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permitto do the work and installation as indicated.
4!1ronsideration
rtifythatnowork or installation hascommenced priorto the issuance of a permiturie Counttyy makes no representation that is granting a permit will authorizethe permit holderto build the subject structure
ch is in cortfiictwith any applicable Home Owners Assocraiion rules,bylaws or and covenants that may restrict or prohibit such
cture.Please consult with your Home Owners Assodatibn and review your deed for any restrictions which may apply.
ofthe granting of this requested permit,]do hereby agree that 1 will,in all respects,perform the work
ii s accordance with the approved plans,the Florida Building Codes and St.Lude County Amendments.
Th�following buIld ding permit applications are exempt from undergoing afull concurrency revievr.room additions,
all ccessory structures,swimming pools,fences,walls,signs,scree_n 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
in1provements 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 reeordin our Notice of Commencement.
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51gn a of Owner/Agent/Lessee Si re of Contractor/License Holder
S ATE OF FLORIDA �J STATE OF FLORIDA
COUNTY OFCOUNTYOF
e�foe foreoing instrunwirit was ayknowlecigg-4 before me The forgoing instrun entwas acknowledged before me
day of e K-h..,__.Z0/`-by this day of 20 by
(Name of person acknowledging) (Name of person acknowledging)
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I( i atu of Notary Public-State of Florida) Isi atu of Notary Public-State of Florida)
P oreal[y Known L--"OR Produced identification Personally Known ri OR Produced Identification
Type of lderrtifCcation Produced - Type of Identification Produced
ChA
Juiet Law
i mmission No.� '0 07 - S NOTARYPUBL1
MOl�f1d IJ1f1,ON STATE OF FLRR I A
�evised
.. " s moires 1111 ,. 120 0711512014 -
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EVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RCEIVED
PATI_
COMPLETED
it
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