HomeMy WebLinkAboutBuilding Permit Application I
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ALL APPLICAB:_E INFO MUST 3E COMPLETED FOR APPLICATION TO BE ACCEPTED (� (�
Date:,z� {vi 7a . Permit Number l047-q D'-'
Ap�2
- - Building Permit Application per's%fr; ?0�9
Planning and Development Services S•z[,�9Oepd
Building and Cade Regulation Ciuision e Coe "c/ eqt ;1
230D Virginia Avenue,Fort Pier:e FL 34982
Phone: (772)462-1553 Fax::(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical : 0
PROPOSED INPROVEMENT LOCATION:-
Address: /4' • '}, a.) j:,
}, -4
Legal Descripti bn: •
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f_ Property Tax ID#: 1301-111-0001-000/5- -' - Lot No_
Site Plan Name: Block No_
Project Name:
Setbacks Fro:it : Back: Right Side: Left Side: ,
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack _
CONSTRUCTION INFORMATION: -
dditional work to be performed under this permit—check all the apply:
HVAC ,Gas Tank Gas Piping I— Shutters Windows/Doors
/ E;ectric i Plumbing _ Sprinklers Generator _Roof
Tota'Sq.Ft of Construction: 59_Ft.of First Floor:
Cost of Constr_ction:$ J`" 00= 0a Utilities:I _Sewer _Septic Building Height:
OWNER/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:' FL
Phone No_ 772-878-5513 j Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No. 772=971-4512 ,I
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 consruction is$2500 or more,a RECORDED Notice of Commencement is required. •
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ;/ Not Applicable MORTGAGE COMPANY: _moi Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: V,Not Applicable BONDING COMPANY: V Not Applicable
Name: Name:
Address: Address:
City: City:
I' Zip: Phone: Zip: Phone:
{ '
I I certify that no work or installation has commencedprior to the issuance of a permit.
I 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 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.'
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
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in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
1 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
I before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
Ii commencing work or recordingyour Notice of Commencement.
A
y � / ��`'(�
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9 Si:,ature of Owner/Agent/Lessee Sigfiature of Contractor/License Holder •
STATE OF FLORIDA - STATE OF FLORIDA
•COUNTY-OF SAINT LUCIE COUNTY OF SAINT LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
EI this day of , 40' , 20 LL by this .2l day ofi1.� ,20/7 by •
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__ _,1 NIIES W LAW JAMES W LAW
1 (Name of person acknowledging) (Name of person edging)
4K ,',.
�� i n_-� ti a oT Notary�� Public-State of Signature o otary Public-State of Florida)
(S g / Florida))
Personally Known Ar'.--
✓ OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. GG 046735 ( Juliet Law Commission No. GG 046735 eajg� Law
NOTARY PUBLIC �` NOTARY PUBLIC
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+STATE OFF ORIEL alp �� y . _
.vi!4.1. �,44�y/�c i-
. .,..,,`,_e Commit GG046735 �.,:a'; Commit 03
735
Revised 07/15/2014 I a�,, `1 Expires 11/13/2020- ip Explrea 11/13/020
REVIEWS FRONT I . ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW i
DATE
COMPLETE I
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INITIALS
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