HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:�Q���� �� Permit Number.
RECEP"I ,DEC 16 7015
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-IMPROVEMENT LOCATION::
Address:
Legal Description:
PropertyTax ID#: 1301-111-0001-000/5 ?(:. Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF.INORK
Replace meter center with a combo pack
CONSTRUCTION_INFORMATION:
Additional wor to be nerformed under this permit—check a appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric ❑Plumbing Sprinklers E]Generator a Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 7J , ?}d' Utilities:Sewer 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(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 COMPANY: z/ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: t/ Not Applicable BONDING COMPANY: , Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
1 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 thepermitholder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or an 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.
Inconsideration ofthe 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 work or recordingVour Notice of Commencement.
S
lgriature of owner/Agent/Lessee signature of Contractor/License Holder
ST
COUNTY OF ATE OF FLORIDA STATE OF SAINT LUCIE C LINTY OFORIDA SAINT LUCIE
Thefn- ng instrurp �was�� nowlieclged before me The face Ing i�tn, e s acknowledged before me
this v of 20 by this/ Say �'� .20�'by
JAMES W LAW JAMES W LAW
(Name of person acknowledging) (Name of person acknowledging) '
(Signatui,�N�..;ry Public-State of Florida) (Sgnature Notary-public- of Florida)
Personally Known � OR Produced identification Personally Known V OR Produced Identification
Type of Identification Producer]
Type of Identification Produced
�
NOT, PUBLIC - � Y JULIET LAW
EE 84690E Commission No_ EE 846906 ,erARY PUBLIC
Commission No- — --- TATE OF FLORIDA STATE OF FLORIDA
Comm#EE8469M Com
�s% Expires 10/28/201(
Revised 07/15/2014
FRONT ZONING S UPERVIOVEGETATION SEV LE MANGROVE R PLANS
COUNTER REVIEW REVIEWREVIEW REVIEW
DATE
COMPLETE
INITIALS