HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virgin/dAvenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1S78 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPR.OVEIVIENT LOCATION:
Address: cod IQ < 42 rz:
Legal Description:
Property Tax ID#: 3414-501-17Cl-COO/9 Lot No.
Site Plan Name: Black No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
D&AILED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
CONSTRUCTION INFORIVIATIOW
Adclitional work tobe—nerformed under tnts permit- appy:
check 511 f1lat
HVAC ElGas Tank ❑Gas Piping Shutters Windows/Doors
1.=! M Plumbing []Sprinklers Generator O-Roof
Total Sq.Ft of Construction; Sq.Ft.of First Floor:
Cost of Construction:$ Utilities:0 Sewer OSeptic Building Height:
-OWNER/LESSEE: CONTRACTOR-,
Name Wynne Building Corp. Name: James W Law
Address. 8000 S US#I Suite 402 Company: Law's Efectrio,Inc_
City: Port St. Lucie -State:FL Address:—218 Beach Ai-nue
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. 772-1971-4512
Fill in fee simple Title Holder on next page t if diftrent E-Mail: lawselectriejnc@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 CONSTRUCT ON LIEN LAW INFORMATION:
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MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
Cfty. State: City-, State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY:
_VNot Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone. Zip: Phone:
I certify that nowork orinstallation has commenced.-Priartothe lssuance of a perrmL
St Lucie !makes
which ' ''pIn Ict with a�jprgapplicable e"Mction that eauM Pieconsult rVriomen
sociation and review your deed for any restririons which may apply.
I n consideration of-the granting df this requested permit;,I do hereby agree that I will,in aff respects,perform the work
in accordance mh the approved plans,the Florida Building Codes and St Lucie County Amendments.
The following building permit applic.ations,are exempt from undergoing a full concurrency revIgAw.room additions,
accessory structure--swimming pools,fences,waft,signs,screen rooms and accessory uses t6 another non-residential use
WARNING TO OWNER:Your WI 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 jobsite
before the first inspection.If you intend to obtain financing,consult with lender or an attorney before
commenciM work or recording your Notice of Commencement.
Orgriature of Owner/Agent/Lessee Wature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUN7y OF SAINT LUCIE COUNTY OF SAINT LUCIE
Thafnra " instrumentvrasacknowledeed before me The forading instrument was acknowledged before in
jng C:7- e
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K4
-jA-MES W LAW JAMES W LAW
(Name of person acknowledging) (Name of person acknowledging)'
eA'
Notary Public-State of Florida)
(Jjbmrb�amotary Public-state of Florida j
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced.. Type of Identification Producer'
JUUET LAW
EE 846906 NOTARY PUBLIC ComrWosion No- 846906 ... ' 'PUBLIC
Commission No--- - OFFLORIDA 7�Ry
Corn"SE846900 STATE FLORIDA
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Revised 07115/2014
REVIEWS FRONT ZONING SUPERVISOR PLAINS VEGETATION SEATUIRTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
-DATE
COMPLETE
INITIALS
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