HomeMy WebLinkAboutBuilding Permit Application-see above, corrected address ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date:
-4WA� Permit Number:
MAY 0 0 Z019
Planning a.nd DevelopmentServites Building Permit Application ---M- J
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
PROPOSED INPROVEMENT LOCATION:
Address:
Legal Description;
Property Tax l D#: z/--S-e)- 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
CONSTRUCTION INFORMATION:
Add(tiona)work tobe erformed under this permit–check aapply-;--
E1HVAC Gas Tank Gas Piping FShutters F Windows/Doors
(Electric Plumbing [:]Sprinklers Generator F Roof
Total Sq.Ft of Construction: Sq-Ft.of First Floor:
Cost of Construction:$ C) UtilitiesJ—]Sewer I Leptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp- Name: James W Law
Address: 8000SUS#1 Suite 4012 Company: Laws Electric, Inc.
City: Part St Lucie State:FL Address: 218 Beach Avenue
Zip Code: 34952 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- lawselectricinc@?aol.com
from the owner listed above) State or County License: EROOOD122
I
of Commencement is required.
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9-d -89Z6-699-699
SUPPI EMENTAL CONSTRUCnON LIEN LAW INFORMATION:
ITESIGNER/ENGINEER:- V Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name.,
Address: Address:
c1tv. State: City- State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER:,,/ Not Applicable BONDING COMPANY: _j/_Not Applicable
Name: Name:
Address: Address:
CW.
Zip: Phone-, Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit
StAucieCoun makes no representation that is granting apermit will authorize the permit holder to build the subject structurewhich is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult w h,your Rome Owners Association and review your deed for any restrictions which may apply_
in consideration oMe 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-Lude County-Amendments.
'Che following building permit applications are exempt from undergoing 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 pairing 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
commentingwork or recording our Notice of Commencement.
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Si &M of owner/Agent/Lessee SI tune of Contractor/license Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINT LLICIE COUNTy OF SAINT LLICIE
The forgoing instrument was acknowledged before me ThefoToing instrument was acknowledged before me
thi jo
_day of20 by
is
JAMES W LAW JAMES W LAW
(Name of person acknowledging) (Name of person acknowledging)
(sign a of Notary Public-State of Florida) (Signature d-T-Notary Public-State of Florida
Personally Known „ OR-Produced Identification_ Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Juw Law Amet LAW
Commission Na_ i§GM6735 NOTARY PuF JMminfission No. GG 046735 NOTARY pUBU0
STATE OF pl, )RIPA STATE OF FLORIF
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Revised 07115f2014 rag 11/13/2020
Expires 11t1312(.::,,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE ' MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
I Com' E
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INITIALS
9-d -89z6-699-499 eM:O % 90 AP-Vq