HomeMy WebLinkAboutBuilding Permit Application ALL APPLICA E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l ("�
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Permit Number: I C)
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 INPROVEMENT LOCATION: ,
Address: q 9
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:
[DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
CONSTRUCTION INFORMATION:
--Ad-ditional work to e_ne c a appy:
_
HVAC
Gas Tank ❑Gas PipingOGenerator
Shutters a Windows/Doors
Electric �Plumbing OSprinklers L=l Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ /.��_ Utilities: �SewerFleptic 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.
Cita. 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: ✓ 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 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 work or recording our Notice of Commencement.
Sign re of owner/Agent)Lessee Signafirfe 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 forgoing instrument was acknowledged before me
this 1 7 day of 20 /,S;-by this-.9Sday of Op:�L• .20/S by
JAMES W LAW JAMES W LAW
(Name of person acknowledging) (Name of person acknowledging)
(Signaturef Notary Public-State of Florida} (Signatur f Notary Public-State of Florida}
Personally Known I/:- OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced
Type of Identification Produced
NOTARY PUBLIC JULIET LAW
EE 84690E Commission No. EE 846906 dt11DJTARY PUBLIC
Commission No_ — --- ATE OF FLORIDA
Comm#EE846906 STATE OF FLORIDA
Com
E t9� Expires 10/28/2016
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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COMPLETE
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