HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; �' Permit Number:
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Building
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RECEIVED
�_..:..�... . -. ::_. .__ Building Permit Application
Planning and DevelopmentServices A� �` °I8
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce Ft 34982 `�u� aunty Permitting
Phone:(7721462-1553 Fax:(772)462-1573 Commercial Re I2ew,
PERM1TAPPLICATION FOR:- Electrical Q
PROPOSED INPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID#: 3427-111-0002-00016 tpF Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Hack: Right Side: LeftSide:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
CONSTRUCTION INFORMATION:
-AdcfltionalwarictaineneitarmecI under t is perm►t—c ecic a appy:
EI-HVAC Gas Tank ❑Gas Piping _Shutters E]Windows/Doors
Electric Plumbing []SprinklersEnGenerator C3 Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ ,�` � , �.4-) Utilities:O Sewer 1-1 Septic Building Height:
OWN ER%LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address- 5000 S US#9 Suite 402 Company: 1-a+nrs Electric, Inc.
Com: Port St, Lucie State: PC Address: 218 Beach Avenue
Zip Code: 54952 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: lawselectOcinc@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 UEN LAW INFORMn. bN:
DESIGNER/ENGINEER: % tot Applicable MORTGAGE COMPANY: -�Not Applicable
Name'. Marne-
Address: Address:
city-. State: C! state:
Zip: Phone. Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: NotApplicable
Name: Name:
Address: Address:
city:
Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT*.Application is hereby made to obtain a permitto do the work and installation as indicated.
I
I certify that no work or installation has commenced prior to the issuance of a permit.
St Lode Coun I Wthesubject
I - bylaws or and covenantsthat may restrict or p,
.1,makes no representation that is granting a permit"I authorize the permit hailer to bund irul such
which is in co ict wfth anyApplicable Home Owners Association rules,
1
structure.Please consult w your Home Owners Association and raidewyour deedfor any restrictions Which may apply_
in consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in-accordance widb the approved plans,the Florida Building Codes and St.Lude County Amendments.
-ybefullowing btfliding permit applications are exemptfrom undergoing a full concurrency review:room additions,
accessorystructures,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 1n your paying twice for
improvements to your property-A Notice of Commencement must be recorded and posted on the jobsjte
before
the first inspection.If you intend to obtain financing,consult with lender Oran attorney before
co=enic! work or recording our Nofice of Commencement
Lure ot�t���tl Lessee %ghature of ContractorlLicense Holder
STATE OF FLORIDA STATE OF FLOPJDA
COUNTY OF�ST.WCIE. ' COUNTY OF.— SL WCIE
The forgoing instrurn ant was acknowlefte-c[before me The for-aning instrumentwas acknowledged before me
20.4Lby
JAMES-W LAW JAMES W LAW
(Blame of—persona�dgmg) (NaTnLa of person a&1=61edging)
(Signa�j-r-eWfttafy Public-State of Florida
(Si: nate -Notary Public-�SZte of�Fforida�)
Personally Known OR Produced Identffication Personally Known 'OR Produced ldentfficadon
Type of Identification Produced Type of Identification Prodtnaed_
Commission No. Juliet Law Commission' imo.Z-, 6-A� (sea()
NOTARYPUBLI
1XI aft Law
Qi A It OF FLORjQA
Af2Y FUBuc
Revised 07115/2014 cormw 0004Ms- OF FLOR10A
Expires 1411 .% STATE. )Comrrw 0
expMes I I/
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATIONsEATuffrLE 4/1
REVIEWS '
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RECEIVED
DATE '
ComPLETED
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