HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
DatePermit Number:
RECEIVE®
Building Permit Application OCT 21 2015
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 Residential X
PERMIT APPLICATION FOR: Electrical
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Address: J .
Legal Description:
Property Tax ID#: 1301-111-0001-00015 e L. Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Replace meter center with a combo pack
Additional work t-6-Fe{ e Orme un er t is permit—check a apply:
E 1HVAC iJ Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
ZElectric 0 Plumbing Sprinklers 13 Generator E]Roof
Total Sq.Ft of Construction: Sq.—Ft.of First Floor:
Cost of Construction:$ ���i�i00 Utilities: Sewer Septic Building Height:
O.ME `i`ESSEE : . C..ON FRAC 'Ot:
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
Hill 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:
DESIGNER/ENGINEER: V Not Applicable M011TGAGE COMPANY: ✓ Not AppTcable
Name: Name:
Address: Address:
City: State: City_ State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: t/ Not BONDING COMPANY: -&/_NotApplicable
Name: Name:
Address: Address:
City: City:
Zip: Phone- Zip: Phone-
!certify that no work or installation has commenced:prior to the issuance of a permit
St Lucie Courcy makes no representation that is granting a permit will authorize the permit holder to bund the subjectstructure
which is in makes
any applicable Home Owners Assoaation rules,bylawsoranci covenants that may restrict or protu-bit such
strucwre.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
in consideration of the granting of this requested permit,1 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 fallowing 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 failemre 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 attomey before
commencing work or recording our Notice of Commencement
i 1h
amre of Owner/Agentj Lessee p6nature of contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUIM OF SAINT LLICIE COUNTY OF SAINT LU[lE
The fns !ng instru t acknowledged before me
The foreoing instru ent ray acknowledged before me
2Db thisday cif 1�o s . .20�by
tiffs ^ day
Of _ Y
,LAMES W LAW JAMES W LAW
(Name of person acknowledging] (Name of person acknowledging)
(Sgr►a Nota Public-State of Florida] (Signatu Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known Oil Produced ldenttfir. on
Type of Identification Produced Type of identification Produced
NOTARY PUBLIC JULIET LAW
EE 84690$ Commission No- -EE 846906 ARY PUBLIC
commission No. — ATE OF FLORIDA STATE OF FLORIDA
. Comm#EE&i6906
. Expires40/26/2016
Revised 07/15/2014
REVIEWS FRONT R REVIEW SUPERVISOR
REVIEW VEGETATION SEATURTLE �
PLANS REVIEW REVIEWMANGROVE
REVIEW
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INITIALS
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