HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE
-�INFO
MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n
Date: �9Ur6 Permit Number: 0:3 ()1
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
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2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:V72)452-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION"-
Address:
Legal Description:
Property Tax ID#: 1301-111-0001-000/5 ,?d- Lot No.
Site Plan Name: I' Block No_
Project Name: I�
Setbacks Front Back: Right Side: Left Side:'
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DETAILED DESCRIPTION OF WORK.:.''. `.
Replace meter center with a combo pack
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CONSTRUCTION INFORMATION-
lona wor to a rme under fis permit—check a appy: I.
1]l NAC 0-Gas Tank E]Gas Piping _Shutters Q Windows/Doors
aElectric Plumbing Sprinklers FIGenerator O Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floor: l
Cost of Construction:$ �� �• ocv Utilities:0Sewer 0septic Building Height:
I.
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 SL Lucie ',i State: FL
Phone No. 772-878-5513 Zip Code: 349521 Fax. 772-878-3347
E-Mail: Phone No. 772-971-4512
Fill in fee simple Title Holder on next page(if different E-Mail: lawseleotricincbaol.com
from the Owner listed above) State or County License: E 110000122
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If value of construction is$2500 or more,a RECORDED Notice of Commencement Is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DFSIGNERJNEER: V Not Applicable MORTGAGE COMPANY:1 �!Not Applicable
Name: Name;
Address: Address-
City: State: City: I State:
Zip: Phone: Zip: Phone:1
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FEE SIMPLE TITLE HOLDER: _I/ Not Applicable BONDING COMPANY: ! Not Applicable
Name: Name:
Address: Address:
City: City: I
Zip: Phone: Zip- Phone: 'r
I certify that no work or installation has commenced.priorto the issuance of a permit.
5t Lucie County makes no representation that is granting a permit will authorize the permit holael r to build the subjectstructure
which is in confiictwith any app8cable Home Owners Association rules,bylaws or ani covenants that may restrict or prohibit such
structure.Please consultwdh your Home Owners Association and review your deed for arty restrictions which may apply.
In consideration of the granting of this requested permit;i do hereby agree that i will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie CountyAmendments_
The following building permit applications are exempt from undergoing a full concurrency reidpw:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to 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 with lender bran attorney before
commencing work or recordigg yQur Notice of Commencement.
S---Eiire of owners Agent/Lessee Siffnature of Contractor/Licenl a Holder
STATE OF FLORIDA SAINT LUCIE STATE NF FFLORIDA
SAINT LiICIE.
COUNTY OF
The�rgoingin t Nledged before me Theft oing inswim wast cknnwledged before me
this, ay of +iol�by rt'is, .day cf ' c�- .�.zO�C.�yy
JAI,l11ES W LAW
JAMES WIAW
(Name of person acknowledging) (Dame of person acknowledging)'
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{5grratureNotary Public-State of Florida J (Signa Notary Pu ;State of Florida)
Personally Known ',/ OR Produced Identification Personally Knowny/blicOR Produced Identification
Type of Identification Produced 1111 AW Type of identification Produced
�TE
ARY PUBLIC JULIET LAW
Commission No_ EE 8"906 Commission No_ EE 546906 Q�1ARY PUBLIC
— - .OF FLOWA STATE of FLORIDA
m EE84&M
Expkwtonb�r2a�s
Revised 07115/20I4 .
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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