HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `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
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION: .
Address:
Legal Description:
PropertyTaxlD#: 1306-111-0001-000le �_ Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
a
CONSTRUCTION INFORMATION:
Additional work toe performed under this permit—check a appy:
HVAC E]Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric 0 Plumbing Sprinklers ElGenerator E]Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ raz 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 LAIN INFORMATION:
DESIGNERJENGINEER: :/ Not Applicable MORTGAGE COMPANY: V Not Applicable
Name: Name-
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _L/—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 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 ofthe granting of this requested permit,l do hereby agree that 1 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 recording our Notice of Commencement.
5itiature of Owner/Agent/Lessee �'ig�nature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINT LUCIE COUNTY OF SAINT LUCIE
The{�� Ing instruct► nt Boras ac owtedged before me The foraging instni Pnt was ac owledged before me
thisGL� day of 1A 20 Z:�-by this��Say o1` &OZ,�W 20Z,.jg-by
JAMES W LAW JAMES W LAW
(Name of person acknowledging) (Name of person acknowledging)
(Signatu f Notary Public-State of Florida) (Signatu a Notary Public-State of Florida)
Personally Known V OR Produced Identification Personally Known V OR Produced Identification
Type of Identification Produced Type of Identification Producers
NOTARY PUBLIC - JULIET LAW
Commission No_ IEE 846906 a NATE OF FLORIDA Commission No. EE 846906 d�DJrARY PUBLIC
Comm#EE846906
STATE OF FLORIDA
Com
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