HomeMy WebLinkAboutBuilding Permit Application i
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ALL APPLICABLE INFO MUST 3E COMPLETED FOR APPLICATION TO BE ACCEPTED G
DatE: Permit Number: O�•O �
Building Permit Application
Planning and VevelopmentSeneices
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierze FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERIAITAPPLICATION FOR: Electrical
PROPOSED INPROVENIENT LOCATION:-
Address:
Legal Description:
I Propert,Tax I D#f: 130 s-1 i 1-0001-00015 ? C' Lot No_
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: RightSide: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack
CONSTRUCTION INFORMATION:
Additionalworkro.13mrformed un ert is permit—check a app y
QHVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Vj Electric Plumbing Sprinklers 1_I Generator Q Roof
Tota'Sq-Ft of Construction: SQ.Ft.of First Floor:
Cost of Constn_etion:$ 6-00- 00 Utilities: Sewer QSeptic Building Height:
OWNERALESSEE: CONTRACTOR:
Name Wynne Building Corp_ Name: James W.Law..
Address: 8000 S US#1 Suite 402 Company: Law's Electric, Inc.
City: Port St_Lucie State: FL Address: 218 Beach Avenue
Zip Zode: 34952 Fax: City: Port St Lucie State: FL
Phone No_ 772-878-55131 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No. 772-971-4512
Fill in fee simple Title Holder on neat page I if different E-Mail: lawselectricinc@aoLcom
from the Owner listed above) State or County License: ER0000122
if value of consauction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGI14ERf El1iGiNEER: e/ Not Applicable MORTGAGE COMPANY: _y/,/Not Applicable
Name- I Name:
Address: Address:
City. State- City: State:
Zip: Phone- Zip: Phone:
FEE SIMPLE TITLE HOLDER: _V Not Applicable BONDING COMPANY: Not Applicable
Name., Name:
Address: Address:
City-
Zip Phone: gip: Phone:
1 certify that no work or installation has commenced.priorto the issuance of a permit
St Lude County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your dome Owners Association and review your deed for any restrictions which may apply.
In consideration ofthe granting of this requested permit,I do hereby agreethat 1 will,in all Irespects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lude County Amendments.
.
The following building permit applications are exempt from undergoing a full concurrency revIiew:room additions,
accessory structures,,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER Yourfailure to Record a Notice of Commencement may result in your payingtwice 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 attomey before
commencing workor
`rarrinjing your Notice of Commencement
vow
re of Owner/Agent/Lessee re of Cantr-actorlUcense Holder
STATE OF FLORIDA STATE OF FLORIDA
'COUJIM OF SAINT LUCIE COUNTY OF SAINT LUCIE .
Thefore ing instrum t was acknowledged before me Thefo ng instrument was acknowledged before me
thrday Of .. 2D by th ay df_.;. 20_y
JAMES w LAW A JAMES W LAW
( e of person acknowledging) (N of person acknowledging)'
(Signature of Notary Public-State of Florida)
(signature of Notary Public-State of Florida)
Personally Known t--� `OR Produced Identification Personally Known ✓ OR Produced Identification
Type of identification Prrgdu'cced f Type of identification Produced
Commission No. �f l _? [ r�3 Commission No._.F J� �� {Seat-
"'''�` ;. ANNj:BRO WALMACH .�;;�;'•••
Revised 07/15/2014 [a
I 'wlEXPIRESAprfl21,2020 - MY COMMISSION#FFW663
�ae otm Fiorlrte `=?a EXPIRES AP
_ nl 21.2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGFCATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INffIALS
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