HomeMy WebLinkAboutBuilding Permit Application ALL APFUCABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 d
Date: Z¢fz 02'r Permit Number:
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Building Permit Application
Planning and LleveioomentServices
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED iNPROVENIENT LOCATION:-
Address:
OCATION:Address:
Legal Description:
Property Tax ID#: 1301-111-D001-00015 ? Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Righ:Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center v6th a combo pack at each address
CONSTRUCTION INFORMATION:
itiona wor to e e orme under tis permit—check all tbA appy:
HVAC GasTankFIGas Piping Shutters Windows/Doors
Electric Pl imbing Sprinklers U Generator Roof
Total Sq.Ft of Construeion: SFt.of First Floor:
Cost of Construction:$ wi OL3 Utilities Sewer Septic Building Height:
1'-OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US#1 Suite 402 Company: Laws Electric, Inc.
City: PoA St. Lucie State: FL Address: 218 Beach Avenue
Zip Code: 34952 Fax: City: Port St.Lucie State: FL
Phone 'Vo. 772-878-5513 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No- 772-971-4592
Fill in fee simple Title Holder on next Page{ if different E-Mail: lawselectricinc@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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f SUPPLEWNTAL CONSTRUCTION LIEN LAW INFORMATION:
�4 DESIGNER/ENGINEER: _ _Not Applicable MORTGAGE COMPANY: _Not Applicable
NaME: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone: f
FEE SIMPLE TITLE HOLDER: ,/Not Applicable BONDING COMPANY: `Not Applicable
Name: Name:
Address: Address: {
Cly: City:
Zip: Phone: Zip: Phone:
OWNER)CONTRACTOR Al FIDVIT:Application is hereby made to obtain a permitta do the work and installation as indicated.
I certify that no work or installation has commenced priorto the issuance of a permit
St_Wde Count�yy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in carruict 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_
I In consideration of the granting of this requested permit,I do hereby agree that 1 will,in all respects,perforin 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
jWARNING TO OWNER:Yourfailure 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
commencing,work ar recording our Notice of Commencement.
Si afore of Owner)Agentj Lessee S nature of Contractor/License Holder
STATE Of FLORIDA ST LUCIE COUNTY FLORIDA
COUNTY OF ST. LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me l
this �� day of �r; ,201.L by this�Z;_day of
JAMES W LAW JAMES W LAW
(ivame of person adkmvel�dging) (Name of person 9tkrra*Iedging)
{sig a of otary Public-State of Florida) (Signature-6f Notary Public-State of Florida)
Personally Known 'Z OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produaed
Commission No. 04jL' Z� Juliet Law Commission ivo_ (Seat)
NOTARY PUBL Juliet Law
o STATE OF El rDa PU13LIC
f ,e Conrn#GG046735 STATE OF FLORIDA
Revised 07115/2014 Expires i 1/13/2020 %'VCor"QGW736
11,V21121
REVIEWS FRONT ZONING SUPERVISOR PLAINS VEGETATION SEA TURTLE MANGROVE
COULTER REVIEW REVIEW REVIEW REVIEW REVIEIIU REVIEW
DATE
RECEIVED
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