HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
G�` /7 /(� Permit Number:
ECEPYE
Building Permit Application MAR 17 2016
Planning and Development Services
Building and Code Reguicdon Division Lucie County, FL
2300 Wrginia avenue,Fort Pierce FL 34982 St. L
Phone: (772)462-1553 Fax:(772)462-7578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical El
PROPOSED_ IMPROVEMENT LOCATION:
Address: a4571.F
Legal Description:
Property Tax ID#:, f To��� ���-- a�� � T Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: LeftSide:
DETAILED DESCRIPTION:OF WORK:
CONST ICTlON:WFORMATION.-
itiona wor o e e rme under this permit—c ec a apply:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
EJElectric Plumbing Sprinklers El Generator Roof
Total Sq.Ft of Construction: Sq.Ft of First Floor:
Cost of Construction:$ DOD. 10e Utilities: Sewer DSeptic Building Height:
OWNER/LESSEE: -CONTRACTOR:
Name Name: JAMES W LAW
Address: Company: LAWS ELECTRIC, INC.
city: State:FL Address: 218 BEACH AVENUE
Zip Code:_ �� Fax: City; PORT SAINT LUC{E She; FL
Phone No. Zip Code: 34952 Fax: 772-971-4512
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 fisted above) State or County License: ER 0000122
if value of construction is$7500 or more,a RECORDED Notice of Commencement is required.
6'd -89Z6-199-699 L17£E8L9ZLLMv9 e9641, 96 L6 JEN
1W
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESiGNERJI;RiGiNEER: •./ Not ApplicableMORTGAGECOMPANY: ✓ Not Applicable
Name: Name:
Address: Address:
CW_ State: city-- State-
Zip: Phone: Zip.,
Phone:
FEE SIMPLE TITLE HOLDER: V Not Applicable BONDING COAVANY.- Not Applicable
Name: Narne:
Addrtiss: Address:
City: .ty.
-Phone: p: Phone:
I cart ythat no work or installation has commenced-priorto the issuance of a permit
5t.Lucie coma
makes n
orePr
representation 0
that is
granting a germ/ will autrorize theaerm hotdetto build the
reh
which h airy
applicable
t�mrers Assocaation rules,bylaws or an covenarststhat may restrict or prohrrit
c
hu� ea cot7your
House O
in ofthe ed permvt;t do hereby agree that i will,in ail respects,Perform the work
in accordance I the plans,
Ians theVida
Thefollowing building permlit.applications are exemptfrorn undergoing a full concurrency review:room additions,
accessory strumvres,swimming pools,fences,walls,signs,screen moms and accessory uses to another non-residential use
WARNING TO OWN EIL,Your failure to Record a Notice of Commencement may result in your paying twice fear
improvements to your property.A Notice of Commencement must be recorded and posted on the jobstte
before the first inspection.tF you intend to obtain financing,consult with lender or an attorney before
commen!;Lnn
&work or recording your Notice of Commenceme-
t-
sigtfftune of owner/Agent/Lessee Signature jikdoa_�ctor/Ljcense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUPM OF SAINT WCJE COUNTY OF� SAINT LUCIE
Thefnrooingliastrumjgntygas;trlk puledgedbefore me Theibradinginstr was-ac qwledged before me
this�y of 7 202a,
this day of
M=26,44
IA-MES WLAW JAMES WLAW
[Wame,of person acknowledging) (Name of person acknowledging)-
(Sigrtabim idPNotary Public-State of Florida I (Signa n~ Notary Fabric-State of Florida
pWsonally Known OR Produced Identification Personally Known V/' OR Produced Identification
Type of Identification Produced_ 11111131 1 AW Type of Identification Produce,' JULIET LAW
conunisslon No- EE$46906 NOTARY PUBLIC Commission No- 846906 _jA1 Llft,=Y'PU13uc
OF FLORIDA
CommSEE846906 STATE OF FLORIDA
AM-6-A E
r
Comma
ComnA EE84MM I
_E nis;10128=10' W
Expires lomamirs
Revised 07/15/2014 ti
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE '
COMPLETE
INITIALS
Z,d -89Z6-199-699 LtC09L9ZLLMV-1 e9641, 96 L!, JBVq