HomeMy WebLinkAboutBuilding Permit Application ALLAPPLICARi.;INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater Permit Number: lCv4 G— �3 0Ile
RECEIV70 JUS! 0 6 2016
Building Permit Application
Plonning and Development Services
Building and Code ReguldWon Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical 0
PROPOSED INPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID#: 3414. 501-1701-000/9 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 oe performed un ert is perm —check all appy:
�
UHVAC UGasTank ❑Gas Piping _Shutters aWindow's/Doors
LJ Electric 1:1 Plumbing Sprinklers a Generator EIRoof
Tonal Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ ,,_ 5 O_' t7C) Utilities. Sewer F]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name.• James W Law
Address: 8000 S US 41 Suite 402 Company: Law's Electric, Inc.
city_ Port St.Lucie State: FL Address: 298 Beach Avenue
Zip Code: 34952 Fax: cit,_ Port St.Lucie State: FL
Phone No. 772-878-5513 Zip Code: 34952 Fax: 772-878-3347
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: ER0000122
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
l•'d -89Z6-699-699 Lt££8L9ZLLMVI 990:60 91, 90 unp
SUPPLEMENTAL CONSTRUCnON LIEN LAW 1NEORMAMON:
D SIC7NEIiJENGiNE1rR: •.� Not Applicable - -- MOOGAGE COMPANY: ✓ Not Applicable
Name: Name:
Address: Address.,
MY= State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: V Not Applicable BONDING CCIMRAIIIY -f NcFt Applicable
Name: Name:
Address: Address:
Cityr
Zip: Phone: 2Sp: Phone:
1 cerb'fy that no work or installation has commenced•priorto the issuance ofa permirt.
St.Lode GQ4�makes no representation that is granting apa_nnft nsrr'21 authorize the erntit holder to build the subjectsiruct<rre
which is in rctwah amr applit�ble Hame OrnmersAssoaaban sulAs,iaptaws�r and couenas that may restxict or pcoflfiit such
structure.Please consult with your Home Owners Assodat3on and review yourcleed for any restrietigns which may apgty.
in consideration afthe granting ofthis requested perms 1 do hereby agreethat I will,in all respect4 perform the work
in sa w dancewith the approved pians,the Z:Wda Bullfrog Codes and St-Lude County Amendments.
Thefollowing building pennit applie ions are eoemptftom undergoing a full concurrency review:room additions,. '
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses 6 another non-residential use
WARNING TO OWNEW Your failure to Record a Notice of Commencement may result in your paying twicefor
improvements to your property.A Notice of Commencement must be recorded and pasted on the jobs'Lte
before the first inspection.if you Intend to obtain financing,consult v tt►lender or an Corney before
corpmencing work or recordiqj32ur Notice of Commencement.
err
S &tore of ownerl Agentj Lessee ature of ContractorjLicense Holder
STATE or-ELORIDA = - SPATE OF FLORIDA
t:OUNCY OF SAINT I.LICIE COUNTY OF SAINT WCIE"Ibe ,
Thefa' _'tag insLsurr has dm me thL f+orr�oing Instru �� ,uv_aT lmm4iedged before me
this of � �Y Q!�i'rm.AL
��.••�_ Y
_S-MES VV LAW JAMES W LAW
boat—e of person acknowledging) (Name of person acknowledging I
{SI Nota Public-SiaCe of Ftodda j (S&rsahr Notary Public State of Florida
Personauy Known OR Produced Idenfilk ation Personally Known V OR Produced Identification
Type of lderrtifrcafon Produced U AIN Type ofldentification Produced
€E 84fi906 NOTARYPL�C Aff.Al=
JULIET LAW
Commission tvo. 691OFFLORIVA Ccmmrsdon No_ E£946906UBL.IC
CommEE64t 6 FLORMA
' � E �arr�e�zois
Revised 07/15/2014 .
REVIEWS FRON17 ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
F3ATE .
COMPLETE
IIUMA1.S
Z'd -8526-199-699 Lb££8L9ZLLMV1 B90:60 96 90 unr