HomeMy WebLinkAboutBuilding Permit Application J
ALL APPLI BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /
Date: �7 0 Permit Number: i l- 0T 0,15i0
A:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553. 'Fax:(772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Electrical
.'PR0Pf?5tD IMPROVEMENT LQCATION:
Address:
Legal Description:
Property Tax ID#: 130 11 f-0001-00014 Lot No.
Site Pian Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
£SCRlPTION OF
CONSTRGUIO N I MF.O.RMA O
rtiona wor to e e orme under this permit—check a appy:
HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
I=EElectric Plumbing ❑Sprinklers Generator F--]Roof
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ �J; l� y Utilities:InSewer OSeptic Building Height:
O11a1N /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 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: ER0000122
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
6•d 892 6-699-699 MV1 aZE:01. 91• Ll, 6nV
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DFSIGNERJENGINEER: No1:Applicable MORTGAGE COMV Not Applicable
Name: Marne:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _L/ Not Applicable BONDING COMPANY-. Not Applicable
Name: Name-
Address: Address:
City: City:-
Zip:
ityZip: Phone' Zip: Phone-
I certify that no work orinstalladon has commenced,priorto the issuance of a permit.
St_Luae Coun makes no representation that is granting apermit will authorize the permit holderto build the subject strucure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may,restrict or prohibit such
tr
sucture.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,l 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 Arnendments.
'fhQfoilowmg building Peradt applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses W 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 u+rith lender or an attorney before
Commencinr work or recording ur Notice of Commencement.
IhIXW'
SOita er Owner(Agent/Lessee % nature of Contractor/License,Holder
STATE OF FLORIDA SAINT STATE OF FLORIDA
COl)Nf OF LLit1E
COUNTY OF SAINT LUCIE
The forgoing instrumP twas acknowledged before me Theforgoing instrumem wap acknowledged before me
this ?day of -21)�by this_ ,day of, �S..L.,24d�by
JAMES W LAMP JAMES W LAW
(Name of person acknowledging) (Name&person acknowledging]
w
(Signatu ' f Nota Public State of Florida) (Sgnatu Notary Public-State of Florida}
personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced ILILIPT I AW Type of identification Produced -
NOTARY PUBLIC JUL1Er LAW
FE 945906 Commission No. -EE 845906 .. ARYPUBLIC
Commission No.
ATE OF FLOEiiDA STAT FLORIDA
. Cornm#EE84B9W Com
1 Expires 10128=16
Revised 47115/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
Z•d 8926-699-699 MVeZ6:06 9L Z6 6nV