HomeMy WebLinkAboutBuilding Permit Application• I I
ALL,APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater /S�o�+ — l+� Permit Number:
- Building Permit Application g
Planning and Develooment5ervices MAR I
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLJCATION FOR: Electrical
PROPOSED iNPROVEMENT LOCATION: _
Address:
Legal Description:
Property Tax 1D #: 3414-501-1701-000/9 Lot No.
Site Plan Name: Block No.
Proiect Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack
CONSTRUCTION INFORMATION:
--Additional work to jeDej rme under this permit— check a appy:
rj HVAC U Gas Tank Gas Piping _Shutters Windows/Doors
Electric D Plumbing Sprinklers 11 Generator Roof
Total Sq. Ft of Construction:
Cost of Construction: $
So. Ft. of First Floor:
Utilities:Sewer Septic Building height:
OMMER/LESSEE:
CONTRACTOR:
Name Wynne Building Corp.
Name:
lames W Law
Address: 8000 S US # 1 'Suite 402
Company:
Law's Electric, Inc.
City: Port St. Lucie State: FL
Zip Code: 34952 Fax:
Address:
218 reach Avenue
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 .I
Fill in fee simple Tittle holder on next page (if different
E -Mail:
lawselectricinc@aol.com j
State or County License: ER0000122
from the Owner listed above)
if value of construction is SzsOv or mare, a i tuvRDED [notice of tommencement is requires.
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SUPPLEMENTAL CONSTRUCTION LlEiq LAIN INFORMATION_
i
DESiGiNERJEINGINEER: ,_
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
_ Nat Applicab'ie
Address:
s 020
Address:
!!
Oty:
State:
City:
State:—!I
Zip: Phone:
MANGROVE
Zip: Phone:
u
FEIi SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY:
lNotApp11icab1 Ie
Name:
REVIEW
Name:
I�
Address:
Address:
!I
City:
. '
City:
II
Z'ip: Phone:
;I
Tip: phone:
QYIINERJ CONTRACTOR AFFID1i1T: Application is hereby madeto obtain a permit to do the work and installation as indicated.
1 certify that no work or installation has commenced priorto the issuance of a permit
St. l.ucie County makes no representation that is granting apermit will authorizethe permit holderto build the subject structure
which is in contlict with any applicable home Owners Association rules, bylaws or and covenants that may restrict or prohilAtsuch
stricture. Please consult With your Home Owners Assodation and review your deed for any restrictions which may apply. f
In consideration of the granting of this requested permit, l do hereby agree that I will, in all respects, perform the work
in accordance w" the approved plans, the Rorida 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 roams and accessory uses to another non-residential use
WARNING TO OWNER: Yotw 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 intent} to obtain financing, consult with lender or an attorney before
f.
-g ature of owner/ Agentl Lessee
STATE OF FLORIDA 5i'. LUCIE
COUNTY OF
The fo ainginstrurnent. uasacknowiedgeed.beforeme
this gladay of ���� 2Qj,,g--bv-
Anima
nature of Contractor/license Holder
STATE OF FLORIDA
COUNTY OF ST. WCiE
The forgoing instnunentwas acknowledged before me
11
thiday of _, 20-12— by
JAMES W LAW JAMES W LAW
[Name of person adlmzmftdging) (Name of person a"dtrwhiedging )
tg of otary Public -State of Florida )
Personally Known ' OR Produced Identification
Tyle of Identification Produced
Commission No_ 6,
p,eyised 07/15/21114
(Signature Notary Public -State of Florida)
PersonallyKnown '✓ OR Produced identification
Type of Identification Produued
Juliet Law i tommissionivo.-G�4675- (Seat) I
NOTARY PUBL Q,W4,, Juliet Law !
Comm# 0GO46735
Expires 11113/2020
STATE of
Cance GG
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
i7ACtE
. '
RECEIVED
DATE
CCiMPLEi"ED
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