HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APP ATION TO BE ACCEPTED j�
Date: o?C7fe � —g Permit Number: / -V
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue,Fort Pierce FL.34982
Phone:(772)462-1553 Fax:(77Z)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED IN PROVEMENTLOCAT-ION*
Address: via
Legal Description:
PropertyTax ID#: 1301-111-0001-000/5 L Lot No.
Site Plan Name: Block No,
Project Name:
Setbacks Front Back: Right Side: Left Side:
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CPN5T UCTION INFORMATION::
Additional work toe e orme under iispermit—c ec a appy:
HVAC 11 Gas Tank F1 Gas PipingMGenerator
Shutters Q Windows/Doors
LJ Electric El Plumbing Sprinklers o Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ �"G2�.a� Utilities:OSewer 7Septic Building Height:
OWN RAESSM.- CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US#1 Suite 402 Company: Law's Electric, Inc_
Qty. Port St Lucie State: FL Address: 218 Beach Avenue
Zip Code: 34952 Fax: City: Port St.Lucie State: FL
Phone No. 772-678-5513 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No. 772-971-4512
Fill in fee simple Title Halder on next page(if different E-Mail: lawseiectricinc@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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMA'TION: '
750—GIVERIN GI NEER: NotApplicableabi-� MORTGAGE COMPANY: Not Applicable
Name: Narne:
Address: Address:
City: State: atr- State:
Zip: -Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER. Not Applicable BONDING COMPANY:
-5w—/Ncrt Applicable
Name: Marne:
Address: Address:
CW. cbwi
Zip: Phone: Zip: Phone.
I certify that no work or installation has commenced prior to the Issuance of a permit.
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In consideration of the granting of this requested permit,I do hereby agreethat I wilt in all respects,perforin the work
in accordance With the approved plans,the Florida Building Codes and St.Lucie County Amendments,
-fbefollowing building permit apprications are exempt from undergo-mg a MI concurrency review:room additions,
accessory structures,swimming pools,fences,wags,signs,screen rooms and accessory usest&another non-residermal use
WARNING TO OWNER:Your failure to Record a Notice of Commencement way 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 finandrig,consult with lender or an attorney before
comme,n cing work or record! our Notice of Commencement.
sW4ture of owner/Agent/Lessee -tore of ofcontractor]Ucense Holder
STATE OF FLORIDA STATE OF FLORIDA
couuff OF jjMNT LUCIE couury OF SAINT LUCIE
neforgoing instrulmentwap acknowledged before me The fogo-ing instrument vips acknowledged before me
day of
this _day Q�f_&Z� ao by
-1 A_MX5 W LAW JAMES W LAW
(Name of person acknowledging) (Name of person-acknowledging)
(Signatu-�e&NotariP,ubric-stateofFlorida)
ijoi5fy PCbrvc-State of Florida)
Personally Known OR Produced Ideniffication Personally Known V OR Produced Iderifftation
Type of Identification Produced 110 1EX I AW—, Type of Identification Produced
JLJlJEr LAW
NOTARY PUBLIC
103. EE��qffi Commission No, EE 846906 1AWARY PUBLIC
commission N ATE OF FLONDA _:M,* VTATEo�FLORw
comm EES46M
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"law Expires 10,28f.Me
Revised 0711512014
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