HomeMy WebLinkAboutBuilding Permit Application ALL APPLISARIZ INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:- Permit Number:
RE IV
Building Permit Application JUN 13 2016
Planning and DeveloomentServices
Building and Corte Regulation,Division
1
2300 Wrginia Avenue,Fort Pierce FL 34982
Phone(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERM"APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
I -I-- -
Address: 4 4E
Legal Description:
Property Tax lD#: 3414-501-1701-00019 Lot No.
I
Site Plan Name; Block No.
Project Name:
Setbacks Front Back:_Right Side:_Left Side:
[.DETAI�El) DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
CONSTRUCTION INFORMATION:
Additionei work to be performed under this permit—check all t1lat apply:
0HVAC n6asTank Gas Piping F-15hutters Windows/Doors
iectric FiPlumbing OSprinklers Generator Roof
Total Sq.Ft of Construction: S Ft.Of First Floor:
Cost Of construction:$ 11 itles-11 Sewer
4 Ut Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name I Wynne Building Corp. Name: James W Law
Addres5l. 800031US#1 Suite 402 Company: Law's Electric, lnr-
C1t,r i Port St Lucie State: Fl- Address. 218 Beach Avenue
Zip Code: 34952 Fax: may: Port St. Lucie State.-f L
Phone No. 772-878-5513 Zip Code: 34952 Fax. 772-878-3347
E-Mail Phone No. 772-971-4512
Fill in fee simple I-Itle Holder on next page f 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.
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SUPPLEMENTAL CONSTRUCRON LIEN LAIN INFORMATION:
Nesls ER/ENGINEER: s/Not Applicable MORTGAGE COMPANY: .J Not Applicable
Name: I Narne-
Address:l Address:
city: I State: City: State:
Zip: I Prone: Zap: Picone:
FEE
SIMPLETCCI.EI-]OLDER: NcxtApplicable BONDING COMPANY: NotAppiicable
Naine. Name:
Address:) Address:
City: I=CY=
ZIp: I -Phone-. Zip: Phone-
s '
I certifir thlat no work or installation has commenaedprior to the issuance of a permit~
St.Lucie Connt�makes no representation that is granting a pe it will authorize the permit holderto build the su'bjectstructure
which is In iconfiict wMi a%applicable Home Owners Aso n rulesr try�ws or a>3d wvenanis that may restrict or prata*such
structure.Please consult w your Home Owners Assoc-ration and review your deed forany restrictions whtch may apply.
in considerations of the granting of this requested permit,I do hereby agree-that t will,its all respects,perForim the work
in accordance with the approved plans,the Florida Building Codes and St Lucie County Amendment.
Thefallo t g building permit applications are exernptimin undergoing a-full concurrency review:room additions,
accessory s�t ructures,swimming pools,fences,walls,signs,screen rooms and accessory uses'tts another non-residential use
WARTAMG TO OWNER:Your failure to Record a Notice of Commencement may remit in your paying twice for
improvements to your property.A Notice of Commencement most be recorded and posted on the jobsite
before the first inspection.tf you intend to obtain financing,consult with lender or an attorney before
commencin vrork or recordin ur Notice of Commencement.
11 A-0-5�9 -21 !
S ature of Owner/Agent)Lessee Knature of Centractor/Li cense Balder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINT WOE COUNTY OF SAINT LUCIE
The ng Snstrutn t was acknowledged before me The f»re Ing instru ant was acknowledged�+efore me
this, ay of -- r 20 Ggby this day ipg Q99,%—a== -26/,Oy
JAA Lin LAW JAMES W LAW
(Name of arson acknowledging) (Name of person acknowledging) '
(5i Notary Public-State of Florida)
(S Notary Pu ic--State of Florida}
Pessaiiatly Knourn OR Produced Iden ificatiam Personally Known V"' OR Produced Iden ification
Tyne off Identsfscation Produced Type of ldentiflration Producer'
NOTARY PUBLIC �� �W
1EE 946901a Cbmsr�sission Ido- 'EE 846906 ' t GARY PUBLIC
Cornmissil n NO. —-- ATE OF FLORIDA STATE OF FLORIDA
w Cwnn�FEI:8�16406
Exph+as 10/28=16
Revised 07FI5/2014
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REVIEWS )LINTER REVIEW SUPERVISOR
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