HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED + u
Dat .- z&J J-7 �,,R17 Permit Number: 1LID�DCEIVED
4.. 201Building Permit Application
Planning and PevelopmentSentiees04li�Xy'
Building and Cade Regulation Division
230L,Virginia Avenue, Fort Pier•--e FL 34982
Phone: (772)462-1553' =ax: (772)462-1578 Commercial Residential X
P E R f A I T AP :LICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:-
Address
Legal Descripti Dn: -
Propertv Tax 1D##: 13011-111-0001-00015 - 1 Lot No_
Site Plan %lame: Block ilo.
Project:Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack
CONSTRUCTION INFORMATION:
AOCLIVOnal wor to be ertormed under this permit—check a t appy_
F1HVAC Gas Tank Gas Piping _-Shutters ❑Windows/Doors
RV Electric Plumbing Sprinklers 0Generator Roof
Tota Sq. Ft of Construction: S Ft.of First Floor:
Cost of Zonstr•:ction:� f 000-- JCS UtilitiesSewer DSeptic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Narr Wynne Building Corp. Name: James W Law
Address: 8000 S US#1 Suite 402 Company: Law's Electric, Inc.
Port St. Lucie State: FL Address: 218 Beach Avenue
City: ---.--
ode: 34052 Fax: City: Port SL Lucie State: FL
Zip
Phone No. 772-878-5513 Zip Code: 34952 Fax: 772-878-3347
E-Nail: Phone No. 772-971-4512
Fill in fee simple Title Holder on neat page(if different E-Mail: lawselectficinc@aol.com
from the Owner listed above) State or County License: ER0000122 ,
c
G
lfvalue of cons,xuction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION VEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY. NotAppRcable
Name: Name:
Address: Address:
City: —state:— aw. —State:
ZIP-- -Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _VNot Applicable BONDING COMPANY-. Not Applicable
Narne: Name:
Address. Address:
arty:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby in2deto obtain a permit to do the workand installation as indicated.
I certilythat no work or Installation has commenced priorto the issuance of a permit.
S�
Lucie
; hi� such
ure.Please consult�ivt your Horne Cltnmers Association and review your deed far any testrictSons which may apply_
in consideration of the granting of this requested permit,I do heiebyagree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St-Lucie county Amendments.
Thefbilov,fing building permit applications are exemptirorn undergoing a fug concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING To OWNER:YourWi ure 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 jobs'ree
before the first inspection.if you Intend to obtain financing,consult with lender or an attorney before
commendiniz-work or recordist our Notice of Commencement-
"�J/
Si re of lOwner�l gnature of Contractor/License Holder
STATE Of FLORIDA
STATE OF FLORIDA
COUNTY OF ST.LUCIE CC)UNW OF S�T. LUCIE ..
The forgoing instrument was admowleft-d before me The forgoing instrument was acknowledged before me
this .1'?Jday of 01--- ,21jx by this/_-_? day of
JAMES W LAW JAMES W LAW
,I me of person afteviedging) (Name of ger
edging)
(Signa of Notary Public-State of Florida
{Sign �frqotary M�ric-State�of Flo�iida)
Personally Known OR Produced identification Personally Known --*" OR Produced Identification
Type of Identification Produced Type of Identification Prodtrmd_
JuNet Law
Met Law
Commission No.-C_,r..6f?k 7:1 (S NOTARY P j&LnrW'ss'Qn No. TARY PUBLIC
STATE OF --L0RfQA STATE OF FLORIDA
GC446ZMX
Revised 07115/2014 EX011'es 11113/2020 Expires 11/13/2090'-,
REVIEWS FRONT ZOM14G SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DACE
comPLETED
RECEIVED
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