HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Permit Number. 6�G
-D W1 2 3
RECER'
Building Permit Application
Planning and DeveippmentServices
Building and CodeReguldtfon Division
2300 Virginia Avenue,Flirt Pierce FL 34982
Phone:{772}452-1553 rax:(772)462-1578 Commercial Residential X
PERIVIFTAPPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:-
address:
Legal Description:
Propert,/Tax lD#: 1301-111-ODOI-00015 7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back:_Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack
CONSTRUCTION INFORMATION:
Additional work to be verrormed underthis permif—check all t=apply:
1-1HVAC U Gas Tank []Gas Piping OShutters E]Windows/Doors
RElectric F I Plumbing OSprinklers OGenerator El Roof
Total Sq.Ft of Construction: So.Ft.of First Floor:
Cost of Construction:$ Utilities:0Sewer[j Septic Building Height:
OWNERILESSEE: CONTRACTOR:
Name Wynne Building Corp. Name- James W Law
Address: 8000SUS#1 Suite 402 Company: Laws Electric. Inc.
cittr Port St Lucie State:FL Address: 218 Beach Avenue
Zip Code: 34952 Fax, City- Port St Lucia State: FL
Phone No. 772-878-5513 Zip Code: 34-962 Fax: 772-878-3347
E-Mail: Phone No. 772-971-45112
Fill in fee simple Title Molder on next page(if different E-Mail: lawselectficincQeol.corn
from the Owner listed above) I State or County License: ER0000122
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMA11ON:
DFSIGNERjENGINEER: f NOtApplicable _ MORTGAGE COMPANY: ✓Not Applicable
Name- Naine-
Address: Address:
City: State= City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: ,Not Applicable BONDING COMPANY: Not Applicable
Name: Name-
Address: Address:
City:
Zip: Phone- Zip: Phone-
I certify that no work or installation has commenced priorto the issuance of a permit
St.Lucie Cou�yy makes no representation that is granting a pertnFt von'11 a�atorize theermT holderto build the subject struct<sre
which Is in corrflicE with any applicable dome Owners Also on ruled sY aws or an onvenat�ts that may res�iet or prohibiit suci�
,structure.Please consultw,di your Home Owners As�ciation and revrew your deed forany rrstrictionswhrchrray apply
in consideration of thegrandng of tris requested penult,I do hereby agreethat I will,in all respects,perform the work
in accordance with the approved plans,the Florida BuUng Codes and St.Lucie County Amendments.
-rise following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory strudwes,swimming pools,fences,walls,signs,screen rooms and accessory uses tb another non-residential use
WARNING TO OWNER:Your failure tio Record a Notice of Cwnmencen ent may result in your paying twice for
improvements to your proper.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 or an attomey before
commendng work or recording your Notice of Commencement.
.
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Si re of owner/Agent Lessee Slinature of Contractorf license Holder
STATE OF FLORIDA • = STATE OF FLORIDA
COUNTY OF SAINT L1jCIE COUIIITY OF SAINT LUCIE
Thefts - instnFentwaC arknowlimiged-;120d,I] °re me Theforaoing instrur�pntwas acknowledged before me
ay
AME5 W LAME .JAMES W LAW
(Name of person admowledging) (Name of person aclmowledging I
(sem Notary Public--State of Ronda) {Srgnature otary Public-State of Florida)
Personally Known OR Produced Identification Personally Known '✓ OR Produced identification
Type of Identification Produced Type of Identiflca lon Producer _
N07ARY PUBLIC _ r JULIET LAW
•EE 846905 Commission No. EE 846906 ARY PUBLIC
Commission rlo- --- ATE OF FLORIDA STATE OF FLORIDA
. Comm#EE6469M
Ems IM11=1r.
Revised 07115/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS - VEGETATION SEAT'URTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE '
(COMPLETE
INTFIAlS
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