HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i
1 ,0� r'� Permit!Number: !�O'lJ � ' V�A.�
., RECEIVED
Building Permit Application JAS! 19 2016
Planning and Development Services PEWV1IT7iNG
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone:V72)452-3553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical El
PR0P0�lkli=I:NPROVEll ENTtb4 TIOI`4:
Address: 7 —.5
Legal Description:
PropertyTax lD#: 1301-111-0001-00015 '-e— Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
1.. fi* .11
Replace meter center with a combo pack at each address
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r`-U((ona workto e e orme un erth ispermit-checka appy:
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L-..HVAC Gas Tank QGas Piping _Shutters D Windows/Doors
9 Electric 0 Plumbing FISprink€ers 1:1 Generator Q Rcof
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ Utilities: Sewer Septic Building Height:
:CIINNR LESSEE: CONTAG'i OR: .
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$78-5513 Zip Code: 34,952 Fax: 772-678-3347
E-Mail: Phone No. 772-971-4512
Fill in fee simple Title Holder on next page(if different E-Mail: lowselectrictnc@aol.com
from the Owner listed above) State or County License: ER0000122
I f value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DES1GlilERj iliGilllEl~R: s/ Not Applicable MORTGAGE COMPANY: V Not Applicable
Name: Name:
Address: Address
City: State: City:
ZIP: Phone•. Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: y,,,,/Not Applicable
Name: Narne:—
Addriss: Address:
CRY: city:
Zip: Phone.• Zip: Phone:
I certify that no work or installation has commenced.-prilartothe issuance ofe permit.
St.
County mattes na regresematiion stat is grart`s a permit uur�l authore the permit holclerto build tfre subject structure
WV in c ct wuh any appl;cable t#crme Owners Assror�ation safes,bylaws or and covenants that may restrict or prohibit sash
structure
in consideration of the granting of this requested permit,I do hereby 89reethat I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendmerva.
The following biAlding permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen roams and accessory usest6 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 vAth lender or an attorney before
commencing work or recording our Notice of Commencement
Signa re of Owner/Agent l Lessee gnature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINT LUCIE COUNTY 01�-- SAINTWCIE
The forgoing' t :ark—Medged bgfbre me The forgoing instru rient was acknowledged before me
this day a � ,en rs 'BY
a
this
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20 ZNC*y day of
-jA-MES W LAW JAMES W LAW
(Name of person acknowledging) (Name of person acknowledging)
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(sjjAiNotary Public-State of Florida) (Si7gnatu-r-e-Vblotaypublic-Stateof Florida)
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Personally Known —V/ Produced OR Pduced Iderifffication Personally Known %/'*' OR Produced Identification
Type of Identification Produced Type of Identification Produceii
NOTARY'PUBLIC. JULIET LAW
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COM17111ISSIOn N0- M9 ATE OF FLORIDA Commission No_JEE-846906ARY PUBLIC
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SF FLORIDA
CommSEE8469D6 STATE
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Revised 07115/2014 ",WWI Expires 10mame
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGErATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
—DATE
COMPLETE
INITIALS
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