HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number.
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Building Permit Application
Planning and Development Services
Building and Code Regulatfon Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Becbical El
Address:
Legal Description:
Property Tax ID#: j-6 d ay d O r / Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Additionalworictoloe rformed un rt is permit—c ec a appy:
HVAC Gas Tank ❑Gas Piping _Shutters a Windows/Doors
QPlumbing Sprinklers E Generator ED Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ o`ld Od Utilities: Sewer El Septic Building Height:
:'OW.NERJALES. :E: :. dIVTFtACTO#
Name Name: JAMES W LAW
Address: o Company: LAW'S ELECTRIC, INC.
City: State:FL Address: 218 BEACH AVENUE
Zip Code: Z6/_W_ Fax: City: PORT SAINT LUCIE State: FL
Phone No.
in o 44 L Zip Code: 34952 Fac 772-979-4512
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 listed above) State or County License: ER 0000122
tf value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUMON LIEN LAW INFORMATI0I1.
-DESIGNER/ENGINEER: s Not Apptit bie MORTGAGE COMPANY: TVN0;tA;PP11;cable
Name: Name:
Address: Andress:
State:_____ Ccty. State
Zip: Phone: Zip: Phone-
FEE SIMPLE TnU HOLDER: /Nat Applicable BONDING COMPANY ,Vf, tot Appricabie
Name., Name:
Address- Address:
�Y� Crty:
Zlp: Phone: P"- Phone:
I certify that no work or installation has commenced priorto the issuance of a pwri t.
st Uicie Ga�rnakes no representation that is grartnga•permit will audiorkethe perfrift€�oklerto bu1ldthesaubject Structure
struct is in l ct wrth amr�y�r a�gpl C'Ne Home Owners+A�s96d`a aon rales,bylum arena covenants that may restrict or protan such
structure.Please consult taut Your Home 0wnersAsso dation and review your deed for any restrictions whrch may apply_
in consideration ofthe granting of this requested permit;I do hereby agree that!wn in all respects,perform the work
in accordancewith the approved plans;t'he Florida Suilding Cortes and St.Lucie Count FAmen dments.
The following building permit applications are examptfrorn undergoing a full concurrency review:room addjaarg% r
accessory structures,SwirnrningP00%fences,waft signs,screen morns and accessory uses to another non-residential use
WARNING TO OWN19111 Your faik e W Record a Notice of Com encernerit may result in your paying Uvke for
improvementsto your properly_A Notice.of Commencement must be recorded and Posted on the jobstwe
before the first irlspection.If you intend to obtain firiandn&consult witia lender or an attorney before
coMmendng work or recordinnyour Notice of Commencement
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F-ii,11-
vm re of Owner/A enV Lessee of Contractor g /L"roense Holder
STATE OF ILORIDA- STATE OF FLOPJDA
C.QUNTI!OF SAINT LUCIE COUNTY OF SAINT LUBE.
'Fire �oTrrg 4 u was acirn�swTedgad before me �_ urg instr�irfr rpt wa s gcknc+wler3ged before me
this &siay of_ � •. ' a:2p. by '�y o - ' - �-2 =bY
SES W LAW JAMES W LAW
(Dame Of person rite awledging} {Name of person ackttouvledging}
{S Notary Public State of Florida} {Signora sy Public-State of Florida}
Personally Known "+f OR Produced Identgication Personally Known t" OR Produced Identification
Type of Identl cation Produced IIII 1EX I AW Type ofideri ication Produced
EE 846908 NOTARY PUMic - J"" LAW
Corrrrnlssion Wo ATE OF FLOIWA Commis±;ion Nom EE 846906 ARY F USUC
ConnrrerK EE848d908 STATE OF FLORIDA
t Exphvs 10128MOIS
P.gv%sed 07/iM/2014
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