HomeMy WebLinkAboutBuilding Permit Applicaiton ALL APPLIC LE INFO MUST 3E COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: £ � � / Permit Number: I (D
.-c:��asw�ats�rrara+a �
..*50:41410 � Building Permit Application
Planning and Development Setvices
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 n
PROPOSED INPROVEMENT LOCATION:
Address: 2/ d _ � J
Legal DEscripti Dn: 67)1d-•
III
Property Tax ID#l: 1301-111-0001-00015 ?C- • Lot No.
Site Plan Name: Block No.
•
Project:dame:
Setbacks Front Back: Right Side: Left Side:
'I DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack
CONSTRUCTION INFORMATION:
Add!trone wor to •[ee orme• un.er t is permit—c ec a t i- appy:
RHVAC { I Gas Tank 'Gas Piping Shutters n WindowsJDoors
�Eiectric I i Plumbing ri Sprinklers 17 Generator _Roof
Total Sq. Ft of Construction: 5 Ft.of First Floor:
Cost of Constr_ction:$ 4D- ��� Utilities:L_Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address: 80E0 S US#1 Suite 402 Company: Law's Electric, Inc.
City: Port St. Lucie State: FL Address: 218 Beach Avenue
Zip Zode: 34952 Fax: City: Port St. Lucie State: FL
Phone No. 772-878-5513 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone Na. 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.
•
6'd -99Z6-l99-I99 LPCC9L8ZLLMV1 • dg17:l•0 9l• 60 PO
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: V Not Applicable —
MORTGAGE COMPANY: p---"-Not Applicable
Name:. Name:
Address: Address:
City: State: City: • Race: . .
_____
Zip: Phone: Zip: Phone:
- .
FEE SIMPLE TITLE HOLDER: V Not Applicable BONDING COMPANY: v-Not Applicable
Name: Name:
Address: Address:
City: City: - -
Zip: Phone: Zip: Phone:
OWNER/CONTRACMRAFFIDVIT:Application is hereby madeto obtain a permit to do the work and installation asindicated.
I certify that no work or installation has commenced prior to the issuance of a permit
St.Lucie County makes no represent lion that is granting a permit will authorize the permit holderto build the subject structure
which is in conflict 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.
hi consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
fbe 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
commencing work or recording your Notice of Commencement
Signa fre of Owner/Agent/Lessee Sig re of Contractor/License Holder
STATE OF FLORIDA . STATE OF FLORIDA ...xe," - •
cOUNTY OF Ji STATE OF COUNTY OF
-,--
The foreoing ins ant was.acknowledmd before me The for oinginstrrrnt - a .nowledged before me
this,-7 day of 4.:.•r;.r&&-.7..1...),201R„by thie...-T-... ay • - -,d ' 01.E. by
•
77li'l --c" 0 L -r-3 - CSAin e.c 0
(ivame of person acknowledging) (Name of person acknowledging)
- -
0,......„,
[ atuieof Notary Public-State of Florida) ( atu*of Notary Public-State of Florida)
Personally Known 1.--""-oR Produced identification Personally Known r;--- OR Produced Identification
Type of Identification Produced .1...._..• , IIIM121w Jr e of Identification Produced
• •-•June! Law I
Commission No.6-G--45114:,7.... .-4-- ' - :-- . ,5TAT OF FLOORssion No_ 6-6.6 6"---_ ....c1;
,,..- -; ''':- NOTARY PLIFilit
• '• -4; • ; Coinnst$00040735 • - - 'A
Expires 11,/13/2020 ..- •i,:r:,C :- % l
. 1, Z. . ...: r •
••••• ...0, AV:. I
'.. • . . . Expires 11/13/.2190
Revised 07/15/2014 -
I
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
i COUNTER REVIEW REVIEW REVIEW REVIEW I REVIEW REVIEIN
1 ,
DATE - ;
RECEIVED _ '
DATE . •
- .
COMPLETED _,
Z'd -993 L-1.99-1-99 2.17CE9L93LLAAv1 da17:1,0 91, 60 PO