HomeMy WebLinkAboutBuilding Permit Application 1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dat ��• - ' �. filerPermit Number:
X803 —07o0
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��C]MhITY ,I .' .
viBuilding Permit Application
Planning and Development Srvices R�
Building and Code Regulation Division 41q
2300 Virginia Avenue,Fort Pierce FL 34982 Pe R 2a
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential 4''"ti l4/®
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PERMIT APPLICATION FOR: Electrical Coto __
PROPOSED INPROVEMENT LOCATION:
Address: --,. q i
Legal Description:
Property Tax ID#: 3414-501-1701-000/9 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 at each address U
CONSTRUCTION INFORMATION:
Additional work tobe ertormect under this permit—check ail apply:
I1HVAC Gas Tank ❑Gas Piping Shutters IJ Windows/Doors
r
ElElectric 11 Plumbing Sprinklers I-1 Generator El Roof
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ // 0 el, 0C) Utilities: Sewer C Septic Building Height:
OWN ER/LESSEE: 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 Code: 34952 . Fax: City: Port St Lucie State: 1=L
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: 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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[ SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: - i i
I?l=SIGNEIVENGENI:I:R: Not Applicable -
MORTGAGE COMPANY: Not Applicable
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Name: _ - Name:
Address: Address: ,
City: i . State: City: State:
Zip: Phone: ' - Zip: Phone: f
FEE SIMPLE TITLE HOLDER: . Not Applicable BONDING COMPANY: V/Nat Applicable
Name: Name: -
Address: Address:
City: City: •-
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
i certify that no work or installation has commenced prior to the issuance of a permit.
St Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with anyapplicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult iivith 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 agree that l will,in all respects,perform the work
• in accordance with the approved plans,the Florida Buliding Codes and St.Lurie 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 j
commencing work or recording your Notice of Commencement.
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S' ature of Owner/Agent/Lessee re of Contractor/License Holder
STATE OF FLORIDA . _ : STATE OF FLORIDA
COUNTY OF LUCIE - COUNTY OF ST.LUCIE
The forgoing instrument was acknowledged_before me The forgoing instrument was acknowledged before me
this, day of_ -7er.iti ,20 by this qday of. - ,20, by
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JAMES W LAW JAIVMI:S W LAW
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(Name of person adomeliedging) (Name of person atkadoledging)
-(Signatu Notary Public-State of Florida) (Signature!Notary Public-State of Florida)
Personally Known '•✓ OR Produced Identification Personally Known '✓ 'OR Produced identification
Type of Identification Produced - Type of Identification Produced
Commission No.lrG17, Iv
-b .La � � Commission o.Liw .a- 6-/yc7.x,5- (Seal),
F . NOTARY PUBLIC ^..` .lost tat ,
LI, c_ SITE OF FLORIDA art -� ' AR?PUBLIC _
Revised 07/15/2014 .. comm#Gc3r14ei .. 41 `STATE OF
Expires 11/130 �;. ��.OR5 ' ;
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txplroa 1l/133/401
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SIA TURTLE MANtnit 3VE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW '
DATE .
RECEIVED _
DATE
COMPLETED
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