HomeMy WebLinkAboutBuilding Permit Application ALL APPUC BLE INFO MIDST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number_
RECEIV'7D OCT 12 1015
... Building Permit Application
Planning and Development Services
Building and Code.Regulation Division
2300 Virginia Aven ue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address-
Legal Description:
Property Tax]D#: 3414501-1701-00019 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back- -RightSide: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
CONSTRUCTION INFORMATION:
Additional worKTO De pe] orme under This permff-check a appy:
HVAC LJ Gas Tank aGas Piping _Shutters a Windows/Doors
Ft 1 Electric El Plumbing E]5prinklers ElGenerator 0—Roof
Total Sq.Ft of Construction: SFt of First Floor.
Cost of Construction:$ /,�-C Od Utilities: Sewer Septic Building Height:
OWN E R/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 Zap Code: 34952 Fax: 772878-3347
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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
aEStGN RjENGINEEPa ;.�' Not Applicable MORTGAGE COMPANY-
E-
OMPANY- v'' Not Applicable
Name` Name;
Address: Address-
Gty: State` City State`
Zip: Phone- Zip: Phone-
I:EE SIMPLE TITLE HOLDER: Not Applicable .BONDING COMPANY: Not Applicable
Name: Name:
Address` Address.
—
city: atY=
Zip: Picone: Zip: Phone:
i certify that no work or installation has commenced priorto the issuance of a permit.
St.I,ncie Gaun1consuint
makes o representation that is granting a permit sari!!autisorize the i�ermit holder do!wild the subbed structure
which is in conctwith any applicable Home Oanrners Assoa:wtion rules,bylaws orand covenants that may res`triet nr prohiint such
s(rtuiure.Pleawath yhour Hame Owners Association and reuiew your deed far any restriaons which may apply.
in contiderflon of the granting df this requested permits I do hereby agree that I will,in all respects,performs the work
in accordance With the approved plans,the Florida Building Codes and St.Lucie County Amendments.
Thefollowing building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swirritning 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 jobssite
before the first inspFecdon.If you intend to obtain financing,consult with lender or an attorney before
comrnencin work or recordinR vour Notice of Commencement.
gnatvre of Owner/ gent/Lessee tore of Contractor/License Holder
STATE OF FLORIDA - STATE OF FLORIDA
COUNTY OF SAIl1i'C LUCIECOUNTY OF SAEN i Luer.
-rhef�n�ro.n�i,n'g inststi ent res dmowledged before me The forgoing insbnment as owledged before ane
thi�ay of ��. this;/ 1!#ay of CjZ j�,70IS-by
-JAA MES W LAW JAMES W LAW
(Name of person acknowledging) {Name of person acknowledging)
(S Notary Pubr1c-State of Florida) (Sign ce f Notary Public-State of Florida)
Personally Known '✓ OR Produced Identification Personally Known G' OR Produced Identfication
Type of Identification Produced Type of Identification Produced
JUIJEr LAW
NOTARY PUBLIC
EE 845906 _ commission No. -�$45906 - VARY PUBLIC
Commission Pio_ - ATE OF FLORIDA
STATE OF FLORIDA
. Comma EE8A6906
Ebgslm 10128!2018
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION - SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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