HomeMy WebLinkAboutBuilding Permit Application ALL APPLICPLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number. �1 061
440 V
Building Permit ApplicatiRECEIVED
Planning and Development Services
Building and Code Regatation Division NOV 12017
2300 Virginia Avenue,Fort Pierce FL 34922
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Pwftttmg
St. LUCle
PERMIT APPLICATION FOR: Electrical U1MY/ .rL-
PROPOSED INPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax 1D#: 1306111-0001-0001-6) 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 INFORMA71 ION:
Additional work to be ertormed under tfi—isperenf—t—check all that apply:
F]HVAC Gas Tank FGas Piping 11 Shutters Windows/Doors
Electric Plumbing E]Sprinklers Flenerator
D Roof
Total Sq- Pt of Construction: Sq-Ft.of First Floor:
Cost of Construction: Utilities:F]Sewer ElSeptic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Wynne Building Corp- Name: James W Law
Address: 8000 S US#I Suite 402 Company: Law's Electric, Inc.
City: Port St Lucie State:FL Address: 218 Beach Avenue
Zip Code: 3062 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: lawselectticinc@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: ✓ Mot Applicable
Name: Name:
Address: Address:
City: State: Crty: State:
r Zip: Phone: Zip: Phone:
( - FEE SIMPLE TITLE HOLDER: V Not Applicable BONDING COMPANY: ANot Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced.prior tothe issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holderto 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 Home Owners Association and review your deed for any restrictions which may apply_
in consideration of the granting of this requested permit,l do hereby agreethat I will,in all respect,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,
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 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
commenging work or recording our Notice of Commencement.
Siad6ture of Owner/Agent/Lessee Pariature of ContractorlUcense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF SAINT WCIE COUNTY OF SAINT WCIE
The forgning instrument was acknowledged before me TheforgoinginstruMentwas acknowledged before me
this, ay of 20 2y_,by thi> . lay of .f' �-�5�.c% =2Ot7:by
JAMES W LAW JAMES W LAW
( e ofperson acknowledging) (N I of person acknowledging)'
�V � J- �l G
(Signature of Notary Public-State of Florida) ( ignature of Notary Public--State of Florida)
Personally Known ✓ OR Produced Identification Personally Known I-'- OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No_ 6C (13 Commission No.__/�F (Seal]-
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Al ,, EXPIRES Apr( 21F2�1U663. MY COMMISSION#FF9&a63
Revised 0711512014 �,�
Fb�MeN°{srysarviee�m %.,°� EXPIRES Apn721.2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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