HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application DEC3
Planning and Development Services 1015
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: -4-
Legal Description:
Property Tax ID#: o?�� 7d�Z - /d zl-o 6�>4 G — 7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work toe nertormed under this permit—check all thBI appy:
HVAC Gas Tank ❑Gas Piping 1:1Shutters Q Windows/Doors
Electric 1:1 Plumbing Sprinklers F]Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ �D�. Oy Utilities:Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name: JAMES W LAW
Address: Company: LAWS ELECTRIC, INC.
City: State: Address: 218 BEACH AVENUE
Zip Code: Fax: City: PORT SAINT LUCIE State: FL
Phone No. Zip Code: 34952 Fax: 772-971-4512
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: ER 0000122
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
aERJEi11GINEER: ;/ Not Applicable
Name:
MORTGAGE COMPANY': V 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:
• I
1
I certify that no work or installation has commenced- to the issuance of a permit.
St.Lude 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,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.
gnature of Owner/ffgentl Lessee Olature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINT LUCIE COUNTY OF SAINT LUCIE
Thefnrening instru P-ntW f tcknowledged bore me The farW%inginstry ntwas acknowledged before me
thisday _ , 20 ZS by L.Jay:q - 20,&Sr6y
JAMES W LAW JAMES W LAW
(Name of person acknowledging) (Name of person acknowledging)
(Sig&auif Notary Public-State of Florida) (Sign uie f Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known V OR Produced Identification
Type of Identification Produced It ILIETLAyType of identification Produced
FE 846906 NOTARY PUBLIC JULIET LAW
Commission No_ —___
NATE OF FLORIDA Commission No. £E 846906 ARY PUBLIC
Comm#EE846906 STATE OF FLORIDA
Com
a 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
[J�NMALS