HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BEE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: lD c /J Permit Number:
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
PROPOSED INP/ROVEMENTLOCATION:
Address: moi`-4' 6 .[/�d a,:W
Legal Description:
Property Tax ID#: 3414-501-1701-000/9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: 'Right Side: Left Side:
DETAfiLED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
CONSTRUCTION INFORMATION:
Additional wor tobenertormed under tispermit-check all tbal appy:
QHVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
in/ Electric 0 Plumbing L]Sprinklers 1-1 Generator F Roof d'
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ /� �l1'C�= d Utilities: Sewer L]Septic Building Height:
-OWNER/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 t 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ;/ Not Applicable MORTGAGE COMPAW: ✓ Not Applicable
Name: Name:
Address: Address:
City: State:, City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: V Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City_
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced.•priorto the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.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,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 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 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 with lender or an attorney before
commencing worts or recording our Notice of Commencement.
agvl� aV2?�
Si ture of Owner/Agent/Lessee Sigfiiture of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
-COUNTY OF, SAINT LUCIE COUNTY OF SAINT LUCIE
The forgoing instrument was acknowledged before me The fo oing instrument was acknowledged before me
this--Z' day of C&- , 20Y--6�by this day of C42� .20•J��y
JAMES W LAW JAMES W LAW
(Name of person acknowledging) (Name of person acknowledging)
(Signatur f Notary Public-State of Florida) (Signature o otary Public-State of Florida)
Personally Known V1- OR Produced Identification Personally Known L/'*' OR Produced Identification
Type of Identification Produced 1111 lEl I AW Type of identification Producers
1=E 8469- WEA:TE
RY PUBLIC t y JULIET LAW
Commission No_ 6 0 OF FLORIDA Commission No_ EE 846906 NARY PUBLIC
it EE846906 STATE OF FLORIDA
Com
M 19� Expires 10/2812016
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS