HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ^� d Permit Number:
Building Permit e 't Application RECEIVED
Planning and Development Services JAN 2 5 2016
Building and Code Regulation Division
2300 I irginiaAvenue,Fora Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical 0
PROPOSED IMPROVEMENT LOCATION:
Address:
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:
QEI-AILED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
EcONSTRUC["ION INFORMATION:
Addroonalwomfooeigerformed un ert is permit—uneck all thatappy:
0HVAC 13 Gas Tank []Gas Piping _Shutters �Windows/Doors
ZElectric 17 Plumbing O Sprinklers E]Generator D Roof
Total Sq.Ft of Construction: 5,C Ft.of First Floor-
Cost of Construction:$ i ���� U d Utilities. Sewer FDSeptic 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
ltvalue of construction is$250D or more,a RECORDED Notice of Commencement is required_
£'d -89Z1-L99-t99 Lti££8L8ZLLlV1bl 139117:01 91, 5Z UBP
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
-,/ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Natne:
Address: Address:
Clity- State: City: —State.-
Zip: Phone: Zip: Phone:
FEE SIMPLE Tff LE HOLDER: xz—r Not Applicable BONDING COMPANY:
--%/-_Not Applicable
Name: Name:
Address Address:
City-, City:
Zip: Phone: Zip: Phone:
I certifythat no work orinstallation has commenced-prforto the issuance of a permit
re
such
Association and review your deed far any restrictions which may apply.
in consideration of the granting of this requested Permit,I do hereby agreathat I uill,in all respects,perform the work
in accordanceW6the approved plans,the Florida Building Codes and St-Lude County Amendments.
The following building permit applications are exempt from undergoing a full concurrency retile-w:morn additions,
accessary structures,swimming pools,fences,wails,signs,screen rooms and accessory cases to another non-residerytial use
WARNING TO OWNER:Yourfaffureto Record a Notice of Commencement may rewlt in yoEW paying twice for
t�ents to your property.A Notice of Commencement must be recorded and posted on the jobs[e
r
ct first inspection.If you intend to obtain financing,consult with lender or an attorney befbre,
commencing work or recordin-gyGur Notice al'Commencement.
-7-- --
signatdr'e-of own-erl Agent l Lessee -91briature of Contractor/License Holder
St
I �Da e5F1np�w:,fttfoLfl:tiszra
e
tj�ja" pp c ome Oe Owners bi
m:l P t your
li em
re
STATE OF FLORIDA STATE OF FLORIDA
.C(3UNrV6fL_L_____jAINT WCIE COUNTY OF SAINT WCIE
7 he forgoing instWentw--tq;,rknnmdedged before me The forgoing Instruplent Was 2Ckn0WIedgE!d belbre,me
th-this of (k?4Z444d&4,6 20 Zaby tfls,�day of 70Y/&'by
JaMESWLAMP JAMES WLAW
(Name of person acknowledging) (Nameofperson acknowledging)
Wignatuir-e)"- otary public-State of Florida
isii�a�f Notary Public-State of Florida I
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced V 11 REM I AW Type of Identification ProduceA
- — JULIET LAW
NOTARY PUBLIC
Comnilssion NO- EE 846966 OF FLOMDA commission No- -1EE 946906 PUBLIC
STATE OF FLORIDA
C-om"EES46906 CAWM*r;EAAM
phw,�tOFAM 16
Revised 07/1512014
;MFATE G
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
--5A—TE
COMPLETE
INITIALS
LVe09L2zzzMV1 e9lv:06 96 9z ular