HomeMy WebLinkAboutBuilding Permit Application (2) ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date.
/41.0 Permit Number:
r-9 E E D
Building Permit Application
Planning and Development Services JUN 16 7016
Building and Code Regulation Division PEWAITTiNG
2300 167rginia Avenue,Fort Pierce FL 34932 St. Lucie Ccunty, FL
Phone:(772)462-1553 Fax:(772)462-I578 Commercial Residential X
PERMIT APPILI CATION FOR: Electrical
PROPOSEb INPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax il)#-. 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:
Aiddttionalwmtdoe erformed under this permit—check all tbiM apply:
HVAC Gas Tank E]Gas Piping Shutters �Windows/Doors
EjElectric ElPlumbing 13Sprinklers 1:1 Generator D—Roof
Total Sq.Ft of Construction: SQ.Ft.of First Floor.
Cost of Construction:$ E4:20, 0e) Utlifffes:0 Sewer r-1 Septic Building Height
OWNERAESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address:-8000 S US#I Suite 402 Company: Laws Sectric,Inc.
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 Fax: 772-878-3347
E-Mail: Phone No. 772-971-4512
Fill in fee simple Title Holder on next page (if different E-Mail: lavmelectricinc@aol.com
from the Owner Iisted above) State or County License: ER0000122
if value of constructicm is$250D Gr more,-a RECOMED Nadce of CommencemeM b required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
QSIGl11ERf EiQIGINEB: :/ Not Applicab a MORTGAGE COMPANY: .f Not Applicable
Name: Natne:
Address: Address:
CAT. State: Ct1y_- State.
Zip: one: Zap: Phone-
FEE SIMPLE TrfU HOI,®Eft Not Applicable BONDING COMPANY: Not Applicable
Name: Name
Address: Address.
City. City_
Zip: Phone: Zip: Phone:
1 certg'ythat no work or installation has commencedpriorto the issuance ofa permit
St l,uc�Count+ makes no representation that is grarrting a-Ppm l.rtwiiU authorize the permr�holrierto build the subjectstrucWr e
which is in can r~ with any appCrcable Home Ousners Assaciadan rutes�bylaws or and covenants py rohbit such
structure.Please consult with your Home Owners Association and review your deed forany restrictions which may apply.
In consideration afthe granting ofthis requested permit,I do hereby agree that I vall,in all respects,perform the work
in accordance With the approved plans,the Florida building Cod esand St:Lucie County Amendments.
The following building pare nit applicadons;are exemptfro In undergoing a fug con cunrxicy review:room additions,
accessory structures,swimming p00%fences,wags,signs;screen morns and accessory uses t6 another non-residential use
WARNING TO®9 WJ:t.,Norn-failure to Record a Notice of Commencement nray result in your pa*gtWce for
improvements to your property.A Notate of Commencement must be recorded and posted on the jobsrte
before the first inspection.if you intend to obtain financing,consult with lender or an attorney before
-commencing work or recording our Notice of CommencemerrL
Spaof owner/Agent Lessee SIgnature of Contiracbw License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAN-LUCIE COUNTY OF SAINT LUCIE-
Thefrmasing strum latae af*nr%1Nlelged before me The for2+iJrg i _was actcr�uvsdedged before me
ttr' of. _ :_zti lap thim of t '.zof f by
L _
.,S ES W LAW .TAMES W LAW
(Name of person acknowledging) (Name of person acknowledging)"
(Si notary Public-State of Florida) (Signature dftotary Public--state of Florida)
Personalty Known OR Produced Iden cation Personally Known V OR Produced Identification
Type of Identifiealion Produced Type of Identification Produced
NOTARYPUBLIC JUlJIT LAW
Comaimsion No. EE 846 06 ATE OF FLORIDA Comrri�ssion No. • 8"906 Y PUBLIC
Coarrml3 EE$A�t16
CWAT�F_OF FLORIDA
.8469M 1
Revised 07115/2014 iti0i6
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETAMON SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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