HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED { t/
Date: Permit Number: il'(/ r
RECEIVED
Building Permit Application
Planning and DevelopmentServices APR 16 2018
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 Pe rm i�ti n gXD a pa rtm e n
Phone:(772)462-1553 Fax:(772)462-1578 Commercial R sici�e�ti�t ntyr FL
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address:
'Legal Description:
Property Tax ID#: 3427-111-0002-00015 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
CONSTRUCTION INFORMATION:
Additional work to be performed under tis permit—check all that appy:
0HVAC Gas Tank Gas Piping _Shutters QWindows/Doors
Electric 0 Plumbing. Sprinklers FIGenerator a Roof
Total Sq.ft of Construction: S Ft.of First Floor.
Cost of Construction:$ �i�r"G'r �� Utilities:nSewer O Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Mame Wynne Building Corp. Name: James W Law
Address: 8000 S US#1 Suite 402 Company: Law's Electric, Inc.
Cita: Port St Lucie State: FL Address: 218 Beach Avenue
Zip Code: 34952 Fax: City: Port St.Lucie State: FL
Phone No. 772-B78-5513 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 WFORMATION:
ble Not Applicable
DESIGNERIENGINEEft Not Applicable MORTGAGE COMPANY:
Name: Name:
Address: Address:
city: State: City: -_-j3tate:
Zip: Phone: Zip: Phone:
at App!icable BONDIT46 COMPANY: AZNotAppllcable
FEE SIMPLE TITLE HOLDER. 'A
Name.*- Name:
Address: Address:
cfty-*
T,P, Phone- Zip-, Phone:
OV4114ERI CONTRACTOR AFFIDVIT,.-Application is hereby m adetoobtalas 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
LuneCount�yy makes no representatiost that u granting a perrnitwill authorize thedpermit haIder to bund the subjectstru Cure
which Is in casx�Ct vJ�th ar►X applscable Home ovsmers Assor�a#�an rotes,tsylaws oras couenants that may restrict ar prohibit such
strucWrePlease Consult with your Horne C3wnersAssocration and review your deed for any resoictions vulSrch may apply_
-
in consideration of the granting of this requested permit,I do hereby agreethat t Will,in all respects,perform the mark
in accordance vfAh the awmed plans,the Florida Building Codes and St Urde County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,md1milfing pools,fences,waft 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 laying 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 flnandng,consult with lender or an attorney before
commencin work or recordinevaur Notice of Commencement.
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51 Mxre of owner]A9 Lessee re of Contractor/license Holder
STINTEOFFLORIDASTATE OF FLORIDA
C013my OF_ ST.WCIE COUNTY OF
S1% WOE
Thefic, c�inginstTme4was acknowledge—d-bp-fbreme Theforgoingintrumas acknowledged before me
-!Vow.
th, ayof- Z40p,6-,:Z 2QJ-Z!bv thise�'aday orf. Z 20_
by
JAMES W LAW JAMES W LAW
(Name of person ac!kmv�dalng) (Name of person a
(51-gr •mojzry Public-State of Florida) Notary Public-State of Florida)
personally Known OR Produced Identification Personally Known -✓ '+OR Produced Ideriffication
Type of Identification Produced Type of Identification Prodtrized
Com rriission No- 'junet Law [Seal)
NOTARY Puss e JEOW Law
IPA ARYPUBLIC
Rqvised o7/15/2014 CmrW C-G046rJ5F-. rATS OF FLOR10A
Expires 11/1 a?'02" 5MMO GOUS7.'m
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETA11ON SEATURTLE MARROVE
EV:IE:WS: COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW. REVIEW
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