HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:—,, Permit Number. of -(0 LA
Building Permit Application AUG 2 2 201?
Planning and Development Services
Building and Code Reguittion Division PEnU,071NG
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL
Phone:(772)462-1553 Fax:(772)4621578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address: "
. "I".."I- z:
Legal Description:
Property Tax ID#: 1306-111-0001-000le k Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: —LeftSide:
DETAILED DESCRIPTION OF WORK:
Replace meter center With a combo pack:
CONSTRUCTION INFORMATION:
W- ditional worR—to-Yfe nertormed unclerthis pieffn check all apply:
FHVAC D Gas Tank FGas Piping Shutters ' oVirindows/Doors
alElectric I—�Plumbing []Sprinklers Eleieratiir F]Roof
Total Sq.Ft of Construction:=,5 5 Ft of First Floor:
'in Sewer Fil
Cost of Construction:$ utifities. Septic Building sleight:
OWNERAESSEE: CONTRACTOR:
Name - Wynne Building Corp. Name: James W Law
Address: 8000 S US#I Suite 402 Company: Laws EJectric, Inc.
City: Port St.Lucie State: FL Address: 21 B Beach Avenue
Zip Code: 34952 Fax: City: Port 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: lawselectrietnc@aoLcom
from the Owner listed above) State or County License: ER0000122
if value of construction is$2500 or morea 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: L
City: State: City: State:
Zip:. Phone: Zip- Phone:
FEE SIMPLE TITLE HOLDER: _V_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 Lucie Coone�yy makes no representation that is granting a permitwill authorize the permit holder to build the subject structure
which is in cor�flictwith any applicable Homeowners Association rules,bylaws or and cavenatns that may restrict or prohibit such
structure.Please consultwith your Home Owners Association and review your deed for any restrictions hhtch may apply.
In.cor�.sideratian ofthe granting oftWm requested perrnk I do hereby agree that t 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 exempt from undergoing a full concurrency review:room additions,
accessary structures,swimming pools,fences,wails,signs,screen rooms and accessory uses to another non-residential.use
WARNING TO OWNER:Your failure to Record a Nance 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 flnancin&consult with lender or an attorney before
commencing work or recordlDA your Notice of Commencement.
Si ture of Owner/Agent/lessee ature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNW OF SAINT LUCIE COUNTY OF SAINT LUCIE .
The foroning instrum nt was acknowledged before me The to ng instrument was acknowledged before me
th?�lay of. ziJ by thi=ay of Zlwer 2QZY-by
JAMES W LAIN A JAMES W LAW
( "Person acknowledging 1 (N of person acknowledging I
�re v
lumu
�JC�L
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known ✓ OR Produced Identification Personally Known '✓ OR Produced Identification
Type of Identification Produced Type of Identification Produce8
Commission No. F0_1L3 Commission
No._.� /` ��� (Seal}.
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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DATE
COMPLETE
INITFALS '
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