HomeMy WebLinkAboutpermit application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date- Permit Number: OC6
T-A 3
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
23W Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax.(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: ElecWcal
PROPOSED INPROVEMENT LOCATION:
Address: V- 4Law
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 at each address
CONSTRUCTION INFORMATION:
Additional work to be nerfDrmi?d underthIs permit—c ec eapp y:
OHVAC 11 Gas Tank [_]Gas Piping "Shutters ❑Windows/Doors
RElectric Q Plumbing OSprinklers 11 Generator 0110of
Total Sq.Ft of Construction: SQ.Ft of First Floor.
Cost of Construction:$ 4r
Utilities:oSewer[:]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US#I Suite 402 Company: Law's Electric,Inc.
City: Port St. Lucie State: FL Address: 218 Beach Avenue
Tip 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 sirnplel-ttle Holder on next page(if different E-Mail- lawselecwcinc@aol.com
from the owner Listed above) State or County License: ER0000122
if value of construction Is$7500 or more,a RECORDED Notice of Commencement Is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Ei,ESIGNERIENGINEER: Not Applicable MORTGAGE COMPANY: jZ-otApplicable
Name: Name:
Address. Address:
q1ty: State: city: !--State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER-. _j/Not Applicable' BONDING COMPANY: v"Not Applicable
Name: Name:
Address: Address:
c1tr. City:
Zip: Phone: 'Zip: Phone:
OWNER/CONTRACTOR AFFIDVqT-.Application is hereby made to obtain a permit to do the work and installation as indicated.
11certffy that no work or installation has commenced prior tothe issuance of a permit.
St.Curie Coun makes no representation that is granting a permit will authorize the permit holder to build the subject structure
Which is in con%ct with any applicable Home owners Assocfatlion rules,bylaws or and covenants that may restrict or prohibit such
structure.Pleaseconsult with your Hon-se Owners Association and review your deed for any restrictions Which may apply.
11 consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
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iq accordance with the approved plans,the Florida Building Codes and St.Lucia County Amendments.
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The following building permit applications are exempt from undergoing a full concurrency review:room additions,
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accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residentiW use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
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 with lender or an attorney before
commencing work or recording your Notice of Commencement.
Si re of Ownerl Agent/Lessee SI re of Contractor/license Holder
I V
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF COUNTY Ctrl=
The forgoing instrunrignt"llwas.acknowledgped-before me The forgoing instrumer5was acknovilecigtc!before me
this--ZA.day of 20-66L by thisz-ff_day of,-G.> e.5r 201h_bV
Larii)
(Name of person acknowledging) (Name of person acknowledging)
Qb of Notary Public-State of Florida)
!:(SWstur-*of Notary Public-State of Florida
personally Known ✓OR Produced Identification Personally Known i-- OR Produced identification
Type of Identification Produced Type of Identification Produced
JULIET LAW
Commission No- NOTARY PUBIJIMommission No.� JULIXT LAW
STATE OF FLqRIDA XUTARY Ptjl3uc
STATE OF FLORIDA
--4WW Expkes 111MM16 W"IfXIEERM
Revised 07/15/2014 Expkw I OrAW6
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
hECEIVED
DATE
COMPLETED
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