HomeMy WebLinkAboutBuilding Permit Application ALLAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:. - Permit Number: Ci
o _ RECEIV70 OCT 24 2016
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical T'
PROPOSED INPROVEMENT LOCATION: _
Address: o;? w
Legal Description: -
Property Tax ID#: 34.14-501-1701-000/9 Lot No
Site Plan Name: Block No.
Protect Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
CONSTRUCTION INFORMATION:
Additronal work toe pertormed under tis permit—MEER all tm appy:
aHVAC 6as Tank E]Gas Piping Shutters a Windows/Doors
L I Electric 0 Plumbing Sprinklers F Generator F-11 hoof
Total Sq.I t of Construction: SQ.Ft.of First Floor:
Cost of Construction:$_ / C'1"d, Utilities:0Sewer Q Septic Building Height:
OWNER/LESSEE: CONTRACTOR:.
Name Wynne Building Corp. Name: James W Law
Address- 8000 S US#1 Suite 402 Company: Law's Electric, Inc.
City. Port St.Lude State: FL Address: 218 Beach Avenue
Zip Code: 34952 Fax: city_ Port SL 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: EF:0000122
If value of construction is$2500 or more,a RECORDED Notice of commencement is required.
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SUPPLEMENTALCONSTRUCfION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: V NotApplicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: Cray: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: I/Not Applicable BONDING COMPANY: ;,-Not Applicable
Name: Name:
Address: Address:
City: city.
Trp: Phone: Zip: Phone-
OWNERf CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
1 certify that no work or installation has commenced prior to the issuance of a permit.
St Lucie Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult vAth your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St_Lucie County Amendments.
Thefollowing building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
impro'Jements 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 our Notice of Commencement
Sjg#dure of Owner/Agent)Lessee 5 ure of Contractor) icense Halder
STATE OF FLORIDA p�J STATE OF FLORIDA -
COUNTY OF 1J COUNTY OF � o ����.�•�
The forgoing instrum t w s acl owledged_before me The foreoing instrument was cknowledged before me
thfS�ay of 20 by thisQ?�day of 2(l�by
(Name of person acknowledging) (Name of person acknowledging)
-OWabureof Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known &,""OR Produced Identification Personally Known &— OR Produced Identification
Type of Identification ProducedType of Identification Produced
JULIET LAW -4VLIEr LAW
Commission No. NOTARY PUB Ilcommission No.EF&!Z(G fob t v
_ VOTARY PUBLIC
STATE OF FL
i
STATE OF FLORIDA
Expires 10/2812096 fakes 10/2812016
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER RE-VIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
;RECEIV
,DATE
;COMPLETED
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