HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED' i r�
Date: v2®��v Permit Number: 10 -l�/�)°��O
Local-steam
Building Permit Application
Planning and DevelopmentServices
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Resid "retial X;
PERII/IIT APPLICATION FOR: Electrical
PROPO D 1 PROVEMtNT tt3 kTION
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Address- �
Legal Description:
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Property Tax ID#: 1301-111-0001-00015 ?C? ;'I Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Hack: Right Side: Left Side:
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L Ef 1 3 EIESCRIPTi N 5 ::_' -"
Replace meter center with a combo pacw.
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Adclilaonalwonctoloebertormed underthispermit—check all appy:
®HVAC LJ Gas Tank Gas Piping _Shutters F1 Windows/Doors
Electric 0 Plumbing Sprinklers Generator 1, Roof
Total Sq. Ft of Construction: S .Ft of First Floor:
Cost of Construction:$ —5-4000 Utilities:InSewer aSeptic Building Height:
.OWNEAAESSEE CQ( T#t COR:
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US#1 Suite 402 Company: Law's Electric,111
City: Port SL Lucie State: FL Address- 218 Beach Avenue
Zip Code: 34952 Fax: City Port St�Lucie State: FL
Phone No. 772-878-5513 Zip Code. 34952 , 1 Fax- 772-676-3347
E-Mail: Phone No. 772-97,1-4512
Fill in fee simple Title Holder on next page(if different E-Mail: lawselectricinc@aol.com
from the Owner listed abovep State or County License: ER0000122
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V value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
D'ESIGNEFf/E NGINEER !Not Applicable - MORTGAGE COMPAW: ' ✓ Nat Applicable
Name: Name:
Address: Address`
aty: State: C.rty_. l state:
Zip: Phone: Trp: Phone: 1
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FEE SIMPLE TITLE HOLDER Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address' AddressCity: Oar,
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Phone: Tp: Phone_
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I certify that no work orinstallatlon has aornmerced priorto the Issuance of a permIL
St.Wde County makes no representatlan that is grantinga permit will authorizethedpermit holder to build the stibjectstructure
which is in co Ict u arrrrYY a�pplicable Home Owners Assoaation rules,bylaws or an covenams that may restrict or prohibit such
structure.Please consult wBh your Home awnersAssochMon and reviewyour deed for any restrictions which mayapply.
in consideration ofthe granting of this requested perms%i do hereby agree that i will,in all respect,perform the work
in accordance with the approved plans,the Florida Building Codessnd SL Lude County Amendments.
Thefollowin bolding p�applications are exemptirom undergoing a full concurrency rsvigw•room additions,
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accessory sh uetures,swimming pools,fences,walls;figns,screen rooms and accessory uses tia another non-residential use
WARNING TO OWNER:VourlIailure'rto Record a Notue of Commencement may result in your paying
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 vtrrth tender or an attorney before
commencing work or recording ur Notice of Commencement.
4sj �a�fnerj Agent Lessee Signature of ContractortUcense Holder
STATE OF FLORIDA - STATE OF FLORIDA
COUNTI!Ol= SAINT WCIt COUNTY OF SAINT LUCiE
'1lre faraoi instru nt.uas,I dmawied before me
Theinrgo'trg instYu entwa�c arta+rrwledged before me ��of �.�
this;; ;d of _ Y
.,�t�MES W LAMP JAMES W LAW
(Name of person admowledging). (Name of person acknowledging I
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t Notary Public-Stade of Florida) (Signature atary Pubblic- tate of Florida)
Personally Known V � OR Produced IderriAcation Personally Known V OR Produced identcT't on
Type of Identification ProducedType of ldadification P`oduced
1 JULIET LAW
NOTARY PUBLIC
EE 846966 Cornaiission No_ EE$46906 A ARY PUBLIC
coma moron No. —- ATE OF FLOISDA STATE OF FLORIDA
Cmm#EE846806
ti Expires 1012MIS
Revised 07/15/2414
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION • SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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