HomeMy WebLinkAboutBuilding Permit Application I
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ALL APPLJCAR4E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: r cD/7 Permit Number: o h1c�l;J 0
Building Permit Application
Planning and Development.Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 343B2
j' Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electftal
PROPOSED INPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID#: 1301-111-0001-000/5 ' e- Lot Na
Site Plan Name: Block No.
Project Name: "
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address i
CONSTRUCTION INFORMATION: '
AdditionalworktobaneFFormedunder tispermit—check a appy:
HVAC Gas Tank Gas Piping _Shutters vindows/Doors.
ZElectric 0 Plumbing Sprinklers 11 Generator Roof
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Total Sq.Ft of Construction: Sq-Ft.of First Floor:
Cost of Construction:$ Utilities i Sewer Septic Building Height:
OWNERILESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James'W Law '
Address.• B000 S US#1- Suite 402 Company: Law's Electric;,lnc.
City. Part St Lucie State:FL Address: 218 Beach Avenue
Zip Code: 34952 Fax: City: Fort St. Lucie', a State: Ft
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(i#different E-Mail: lawselectricinc@aol.com
frons the owner listed above) State or County License: EROOOD122
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: V Not Applicable MORTGAGE COMPANY: ✓ Not Applicable
Name: Name:
Address: Address:
City: State: City
State-
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _L/ Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: c'►tS►:
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 permit will authorize the permit holder to build the subject structure
which is in con#ilet with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult wrth 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 agreethat i will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and SL Lucie 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 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 twine for
improvements to your property.A-Notice of Commencement must be recorded and pasted on the jobsite
before the first inspection.If you Intend to obtain.financing,consult with lender or an attorney befbre
commen in work or recording our Notice-of Commencement:
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siFo ture of owner/Agent/Lessee Anature of Contractor/Lrcense Holder
STATE OF FLORIDA STATE OF FLORIDA
-COUNT'SOF SAINT LUCIE COUNTY OF SAINT Lt)CIE..
The forgoing instrument was acknowledged before me Theforgoingrnstru entw s'acknowI dged before me
this clay of 20�Zbp thi qday of 20f7;by
JAMES W LAIN JAMES W LAW
( e of person acknowledging) (N of person acknowledging)'
(signature of Notary Public-State of Florida} ( rgnature of Notary Public State of Florida)
Personally Known ✓ OR Produced Identification Personalty Known lf— OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.
ANNE SRO
P!. •` EXPIRES Apr1121�2020663 MY COMIMSSION to F
Revised 07/15/2014 faF884663
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RAN ' ,,,• EXPIRES Apr#21,202o
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REVIEWS FRONT ZONING SUPEFWSOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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