HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /;7 Permit Number:
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Building Permit Application MAY 12 2017
Planning and Development Services
Building and Code Regulation Division
230D Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)4621578 Commercial Residential. X
PERMIT APPLICATION FOR: Electrical
-PROPOSED INPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax[D#: 3414-501-1701-000/9 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:
ACICitronal work to be erformect uncleF-ffi—ts perm-lt--check all that apply:
1—:1HVAC r]Gas Tank F�Gas Piping _Shutters Windows/Doors
ZElectric E]Plumbing Sprinklers Generator Roof
Total Sq.R of Construction: Sq.Ft.of First Noon
Cost of Construction:$ <no Utilities: n SewerE]Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name. Wynne Building Corp. Name: James W Law
Address: 8000SUS#1 Suite402 Company: Law's Electric,Inc.
city: Port St.Lucia State:.FL Address: 218 Beach Avenue
Zip Code: 34962 Fax: City: Part St Lucie State: FL
Phone 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-- lawselectrfcinc@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:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _i/_Not Applicable BONDING COMPANY: ,; Not Applicable
Name: Name:
Address: Address:
City: City
Zip: Phone: Zip: Phone-
I certify that no work or installation has commenced.prior to the issuance of a permit.
St.LucIB Counmakes no representation that is granting a ppermit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners AssocTiation rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult v&h your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that 1 will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Cozies and St Lucie County Amendments.
The following building permit appiizagons are exempt-from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,wails,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your€ailure 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.if you intend to obtain financing,consult with lender or an attorney before
commencing wont or recording aur Notice of Commencement.
Si re of Owner/Agent/Lessee cgnature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COLIN73FOFSAINT LUCIE COUNTY OF SAINT I:UCNE .
The forgoing instrument was acknowledged before me The oing Instrument was acknowledged before me
thilsj!2—dayof c 2o,�Zby his day of 204%:by
.,TAMES W LAW JAMES W LAW
(N person acknowledging) {Name erson adrnowledging}'
(Signature of Notary Public State of Florida} (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known ._ t' OR Produced identification
Type of ider tifica#an Produced Type of identification Produced
Commission No. 9 ._ G Commission No. (Seal)'
ANAIlr BROWN W MACH -'�� +''•. ANNE BROWN WALMACH
WIT tON#FF984683 _ My COMMISSION#F1:984663
Revised 07/15/2014 f407''; a� Ex ru2�,2o20 `:,,.....,•� EXPIRESApsi121,2020
odn : 14071399-0153
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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DATE
COMPLETE
INITIALS
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