HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ` !' /,.0 Permit Number:
V
Building Permit Application -JUN 12 2011
Planning and.Develo,6mentServices
Building and Code Regulation Division
2300 Virginia Avenue,Fort Plerce,FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:,
Address:
Legal Description;
Property Tax ID#- 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:
Replfte meter center wilh a combo pack at each address
CONSTRUCTION INFORMATION:
Aco(cionaiwr—or-k--t-o-banartormed Gas Tank undernispermi-t—r eckallt=appy:
F1HV'AC - — 0
0 E]Gas Piping UShutters Windows/Doors
Electric Plumbing OSprinklers Generator Roof
Total Sq.Ft of Construction: S .
of First Floor:
L
Cffo
Cost of Construction: zk2�:2 a, Dg2 utilities: ewerSeptic Building Height:
7-
OWNERAESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address- 8000 S US#I Suite 402 Company:. Laws Electric, Ino.
City: Port St.Lucie State:FL Address:— 218 Beach Avenue
Zip Code: 34952 Fax: City: Pc'rt St.Lucia
Phone No. 772-87B-5513 Zip Code: 34�52 — Fax: 772-878-3347
E-Mail: Phone No- 772-971-4512
Fill in fee simple"Title Holder an next page(if different E-Mail: lawselectricinc@aol.com
from the Owner listed above) State or County License: ER0000122
ftalue of construction is$25ac or more,a RECORDED Notice of Commencement is required-
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SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNER/ENGINEER: V Not Applicable MORTGAGE COMPANY: ✓ Not Applicable
Name: Name-
Address: Address- `
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: (3ty:
Zip: Phone- Zip: Phone
-
I certify that no work or installation has commenced.priorto the issuance of a permit
St Lucie county makes no representation that is granting a permitwi l authorize the permit holder to build the subject structure
which is in canflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit suds
structure.Please consult with your Home Owners Association and review your deed forany restrictions which may apply-
in consideration ofthe 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 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,signs,screen roams 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.If you intend to obtain financin>;consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Si re of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA - STATE OF FLORIDA
'COUNTVOF SAINT WCIE COUNTY OF SAINTLUCIE, .
Theforwing instrument was acknowledged before me The foe-oing Instrument was acknowledged before me
tFirslay arf , 20 4a by this c day of .20Z%--by
JAMES W LAW JAMES W LAW
(N a of person acknowledging) (Name f arson acknowledging)
(Signature of Notary Public State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced ldehiification Personally Known OR Produced Identification
Type of identification Produced Type of identification Produced
Commission No. J 9 -1 G commission No. 6F9 !9� 42 (Seal-
j1<"`' ANNE BROWN yy SACH ;tia :';•.- ANNE BROWN WALMACH
;�. MT WMMfSSION#FF984663 MY COMMISSION#FF984663
Revised 07/15/2014raoi EXP M APO 21.2320 ",�;.,,. EXPIRES Aprfl 21,2320
)399-0763 FlgIE�NOh r4Q7 34. 163
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
r
INITIALS
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