HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEP.—D FEB 0 8 2016
Building Permit Application
Planning and Development Services
`Building and Code Regulation Division
2300 Virginia Avenue,Fort Plerce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
-PROPOSED INPROVEMENT LOCATION:'
Address: -2 74e) Joh
Legal Description:
Property Tax ID#., Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back:_-Right Side: Left Side:
FDIEfAIILED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
CONSTRUCTION INFORMATION:
Additional work to be verformed under eck all tlial apply:
UGas HVAC 13 !N= FIShutters FlWindows/Doors
PiElectric El Plumbing OSprinklers 1:1 Generator Roof
Total Sq.Ft of Construction: Sa.Ft of First Floor:
Cost of Construction:$ Q-0 -,Q C2 Utilities:0 SewerFleptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address- 80008US#1 Suite 402 Company: Law's Electric, Ina
City: Port St Lucie State:FL Address: 218 Beach Avenue
Zip Code: 34952 Fax: City: Port St.Lucia 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:
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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERIENGINEER7. Z Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: -state: City: State:
Zip: -Phone: Zip: Phone:
FEESiMPLETITLE HOLDER: Not Applicable BONDING COMPANY: -&/—Not Applicable
Name: Name:
Address: AddTvw-_
Zip: Phone: Zip: Phone;
I certify that no work or installation has commenced-prior to the Issuance of a permit.
5t LUdePDUn
makes no representation that is granting a permit Will authorize the permit holder to build the subject structure
Whichisinco Ict Wm any applicable Home Owners Asgodation rules,bylaws or and covenants that may restrict or prohibit such
sUmcWre.please consult w your Home Owners Association and review your deed for anyrestrictions vibich may a0ply,
in cons:TderatlDn ofthearanting of this requested pervilt,I do hereby agreethat I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lurie CiDurityAmendmerim
-rhefollowing building permit applications are exemptfrom undergoing a full concurrency review;room additions,
accessory structures,swirrinfing pools,fences,walls,signs,screen rooms and accessory uses t6 another non-reslidental use
WARNING To oVMER:Your failure to'Record a Notice of Commencement may result in your paVingtialce for
impmvements 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 mfith lender or an attomey before
commencing work or recording your Notice of Commencement.
AW"4 v
Slgrfature of Agentf Lessee ature of Contractor/License Bolder
STATE OF R.OPJDA STATECIFIFLORIDA
COUMV0 COUNTY 0SAINT WCIE
fo !;tru The clau-sledged before me
rhe rgoing in wledged before me g
,20 this, ,;day day
this,gLavv of
_AA_MES W LAWJAMES W LAW
(Nameofperson acknowledging)
[ijame,of pe acknovvledging)
Notary Public-State of Florida) (5rgnM" Notary_public-state of Florida
_Z- OR Produced Identification Personally Known V" OR Produced Identification
Personally Know Type of Identification Producer!
Type of Identification Produced JULIET LAW
Air; NOTARY PUI31JO E146906 MBLIC
EE 846 No.
ission, OF FLORIDA
Comm STATE OF FLORIDA
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INITIALS
INITIALS
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