HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater14L) Permit Number:\roo k—o-�A
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R E C E I V7D JAN 2 5 20116
Building Permit Application
Planning and DevelopmentServices
Building and Code Regulation Division yt
2300 Virginia Avenue,Fort Pierce R 34982
Phone:(772)462-1553 Fax-(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address:
Legal Description:
PropertyTax]D#: 13o6111 0001-000/,o Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back:_Right Side: Left Side:
DETAILED- ED DESCRIPTION OF WORK':
_
Replace meter center With a combo pack aWM,4001im
CONSTRUCTION INFORMATION:
Additional work tobFI
rmed under this permit—check all Mat apply:
HVAC Gas Tank Deas Piping "''_Shutters Windows/Doors
1 -1 F Electric Q Plumbing []Sprinklers Generator Roof
Total Sq-Ft of Construction: So.Ft.of First Floor:
Cost of Construction:$ _'54D6�- C>C9 Utilities:0Sewer F Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Wynne Building Corp- Name: James W Law
Address-- 8000 S US#1 Suite 402 Company: Laws 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: 7�72_-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: ER00001 22
if value of construction is$2500 or more,a RECORDED Notice of Commencement isrequired,
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SUPPLEMENTAL CONSTRUCTION LIES! LAW INFORMAMON:
DIrSIC�#tl l;%I IIIGINEER: Na Applicable MORTGAGE COMPANY: ,/Mat Applicable
Name* Name.-
Address: Address-
Crty. State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE.TITLI:HOLDER: .3/_Not Applicable BONDING COMPANY: -%/—Not Applicable
Name: Blame:
Address: Address-
Zip: Phone:- Zip: Phone:
I certify that no work or installation has commenced priorto the issuance of a pennit.
St lune Countiyy makes no se&;s eniation that is griming a perinitwill author'rce the dpermit holder to build the subject structure
wliicix is in conflict with any alicable Home Owners Assoaataon rules,bylaws or an covenantsthat may restrict or prohibit such
structure.Please consult with your Home 4+�mers Assodatlon and reuiew your deed far any r estriedioris wi iiedi may apply.
in consideration of the granting ofthis requested perrra,I do Hereby agree that i will,In all respects,perform the omit
in accordance with the approved plans,the Florida Building Codes and 5t.Lucie County Amendments.
The fallowing building permit applications are exempt from undergoing a-Full concurrency review_room additions,
accessmry structures,swimming pools,,fences,waits,signs,screen moms and accessory uses to another non-residential use
WARNING TO OWNER:Yourfallure 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 fiinancirig,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signa re of Owned AgeJrt Lessee gnature of CoatractarJLicense Holder
STATE OF FLORIDA STATE OF SAINT LlICIE COUNTY QFLORIDA SAINT WCIE.
COUNTY OF
the g�ing in ent�nrac arknngUledged before me h eforeo'ig instru ent was acknowledged before me
thl�a�:..'"day of f � ,r�e<���d�-• 2t1 G��bY .Y.
JAMES W LAW .LAMES W LAW
;Name of person*acknowledging)
(Name of person acknowlexlging}'
(Sign Notary Public--State of Florida)
(Sgnature otary Pulal"sc--State of Florida}
personally Known OR Produced Identification Personally Known t" OR Produced Identification
Type of Identification Produced -=I AW Type Identification Produced
NOTARY PUBLIC dUUET LAW
EE 846906 Coma�ssion No. .�816906 � ARY PUBLIC
Comnsission No_
ATE OF Flt)RIDA STATE OF FLORIDA
Conirri#
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}i evised 0711512014
::REVIEWS S OR 5 VE3hS MANGROVEITCALtREIIEU REVIEWREV3EW1ENREtlE / REVIkU
DATE
COINPLETE
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