HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 66/
Permit Number- %0 ZL-G
RECEI . -D FEB 0 8 2016
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 I NPROVEMENT LOCATION:
Address: -6-9 e-747ezp� 1-')77
ziaQ
Legal Description:
Property Tax ID 3414-501-1701-00019 Lot No.
Site Plan Name; Block No.
Project Name:
Setbacks Front�_ Back: -RightSide: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center With a combo pack Ow
I-CONSTRUCTION INFORMATION:
Acicirtionalwarxionenertormed under this permit--c e all apply:
E1HVAC Gas Tank E]Gas Piping —Shutters E]Windows/Doors
Electric Q Plumbing OSprinklers 01Generator El Roof
Total Sq.Ft of Construction: Sa.Ft of First Floor:
Cost of Construction:$ Utilities:13 Sewer OSeptic Building Height:_
OWNERAESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address-- 8000 S US#1 Suite 402 Company: Laws Electric, Inc.
may. Port St Lucie State: FL Address:- 218 Beach Avenue
Zip Code: 34952 Fax__ City: Port St.Lucie State: FL
Phone N.._172-878-5513 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: lawselectricincQaol.com
from the owner listed above) State or County License. ER00001 22
if value of construction is$250D or more,a RECORDED Notice of Commencement is required.
gd -99z 6-499-695 80-V:60 91, 80 qej
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
-DE9IG111ER/ENGINEER: v Not Applicable MORTGAGE COMPANY: ✓ Nat Applicable
Name, Narne:
Address: Address:
Crty: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE Tn1E HOLDER; 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 Conr�t�r makes no representation that is grarting a permitwili authorize the permr�holder to build the sri6lectshucture
which is fi conflict with ar►x applicable Home owners Assocratiorr rules,bylaws or and oovenantsthat may restrict or prohibit such
structure.Please consult with your Home�wriers Association and review your deed forany sesdlctior>ss which nray apply.
In consideration ofthe granting of this requested permit;l do hereby agreethat 1 will,in all respects,perform the work
in accordance withthe approved plans,the Florida Building Codes and St Lucie County Arnendments.
The following building permit applications are exemptfrom undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signsscreen rooms and accessory usestb 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 most be recorded and posted on theiobsite
before the first inspection.If you Intend to obtain financing,consult wrth lender or an attorney before
commencing work or recordina your Notice of Commencement.
Sgnare of Owner/Agee Lessee Srgnature of ContractorlUcense Holder.
STATE OF FLORIDA - STATE OF FLORIDA
COUNTVI OF SAINT LUCIE COUNTY OF SAINT WCIE
Th�e-w a-yl yinstr=,entwac ark -wladg d re me thThefo �g�ostrts nt was acknowledged before me
. d .
_jAMES W LAW JAMES W LAW
(Name of person acknowledging l (Name of person acknowledging)
(Signa f Notary Public-State of Florida)
(Sgnafure otary Public-State of Florida)
Personally Known OR Produced Iden#ilication Personalty Known V"' OR Produced Idenrdication
Type of Identification Produced Type of Identification Producers
EE 846906 NOTARYPUBLIC - Y JULEr LAW
Commission No_ ATE OF FLORIDA Cornarission No_ EE 846906 r!S�TA�
RY PUBLIC
Corr�EE846906
OF FLORIDA
E1 Expires 10@Mis
wised 0711512414
REVIEWS FRONT' ZONING SUPERVISOR PIANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
HATE
COMPLETE
INITIALS
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