HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED IRS,
Date: -'1' _ Permit Number:
c
���.::�,:��
i,....18 I ra,i3 rS z:
Building Permit Application �%',
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone:(772)462-15S3 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEME,NT LOCATION:
Address:
Legal Description:
Property Tax ID#: 3427-1'41-0002-000/5 A! Lot No.
Site Pian Name: Block Na.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack
CONSTRUCTION INFORMATION:
Additional wor toe performed under this permit—check all that appy:
(
QHVAC U Gas Tank ❑Gas Piping _Shutters F Windows/Doors
Electric Plumbing Sprinklers FIGenerator Q Roof
Total Sq.Ft of Construction: Sq.Ft.
of First Floor:
Cost of Construction:$�j'C)Q- �7 e-) Utilities:LTJ Sewer L_J Septic Building Height:
OWNERAESSEE: 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 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 Owne1r listed above) State or County License: ER0000122
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: V Not Applicable MORTGAGE COMPANY: V N'
ot Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: t/ Not Applicable BONDING COMPANY: --%L/Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the Issuance of a permit.
St.Lucie Coun 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 ofthe 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.
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
before the first inspection.If you Intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
SItoreot Owner/Agent/Lessee see Sipffiat6re of Contractor/License Holder
STATE OF FLORIDA = STATE OF FLORIDA
'COUNTY OF SAINT WCIE COUNTY OF SAINT LJUCIE
The forgoing instru ent wa acknowledged before me The forgoing instrument was acknowledged before me
./�7 day I� this qday of
this. 0 . 20 by 20,,Y by
V
JAMES W LAW JAMES W LAW
(Name of person acknowledging) (Name of person acknowledging)
(Sign bwfii'd3f Notary Public-State of Florida) (Signature oT-Notary Public-State of Florida
Personally Known Jeo"' OR'Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Junet Law Jul LAW
Commission No. 046735 NOTARY PU Ctimmission No. GG 046735
NOTARY PUBLIC
STATE OF I 4A
comrm"rw GG FL . STATE OF FLOR1r
Z35 w
i mp--
Expires 11/13/2020
Revised 07/15/2014 Expires 1/13/26,,,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW— REVIEW
DATE
COMPLETE
INITIALS