HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _ ��l� Permit Number: ,!5 1 I `(3 a� l
RECEI�'�p NOV 04 2015
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 Residential X
PERMIT APPLICATION FOR: Electrical
--PROPOS-Eb-I NPROVEMENT LOCATION:
Address•
Legal Description:
PropertyTax ID#: 1301-111-0001-000/5 e L Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DET AUP10 tPT10N Ol`WOR.:.4 ;
Replace meter center with a combo pack
CONSTRUCTION INFOR-MATZO
Additional work toe e orme under this permit—c ec a apply:
HVAC E]Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric F�Plumbing Sprinklers 0 Generator D Roof
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ �, � Utilities:Sewer Septic Building Height:
OWNEWLESSEE: CONTRACT-OR:
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: PL
Phone No. 772-878-5513 Zip Code: 34952 Fax 772-078-3347
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.
£•d -99Z1•-�99-1.99 LV££8L8ZLLMVI e6,V:80 9L 'b0 AoN
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: ✓Not Applicable
Name: Name:
Address: Address:
Gty: State: City- State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _y/ Not Applicable BONDING COMPANY: --%e/—Not Applicable
Name: Name-
Address: Address:
City: City:
Zip: Phone: Zip: Phone-
I certify that no work or installation has commenced prior to the issuance of a pennit.
St.Lucie Count
yy makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict with any applicable dome Owners Associatlon rules,bylaws or ancovenantsthat may restrict or prohibit such
structure.Please consult with your Horne Owners Association and review your deed for any restrictions which may apply-
In consideration ofthe granting ofthis requested permit,I 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 following building permit applications are exemptfrom undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-res'sdential use
WARNING TO OWNER:Yourfaillure to Record a Notice of Commencernerit 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
commencing work or recording ur Notice of Commencement.
Sign re of Ownerj Agent!Lessee 54nature of Contractor/license Holder
STATE OF FLORIDA STATE SAINT LUCIE CO NTY
FLORIDA SAINT LUCIE
CDUNT1f OF '
-fhe forgoing instrtmentwas acknowledged before me The forgoing insmsne�was acknowledged before me
11115 day of � �.ZC�6'<by
this�day of 20�4"bp •
_JAMES W LAW JAMES W LAW
(Name of person-acknowledging) (Marne of person acknowledging)'
(S'ignatu f Notary Public-State of Florida) (5gnaturef Notary Public State of Florida)
Personally Known OR Produced Identification Personally Known S/ OR Produced Identification
Type of Identification Produced Type of Identification Produced j—MrSLTATE
L(WATEOFFLOPJDA
TARY PUBLIC JULIET LAW
EE 846906 Commission No. £E 8469906Y PUBLIC
Commission No._ —- rrlm*��� CiarnmArFEARM
OF FLORIDA
Expires 10128!2016
Revised 071151201.4
REVIEWS FRONT ZONING SUPERVISOR. PLANS' VEGETATION • SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS '
�'d -89Z6-699-699 L1V009L8ZLLMVl e09:80 9L -V0 AON