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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED o c Q�n
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Date: a2Q11 Permit Number: XI�'
ECEIVE
Building Permit Applicatio `
Planning and Development Services OCT 2 5 2016 1
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 31982
Phone:(772)462-1553 Fax: (172)462-1578 Commercial MS.I ential X
PERMIT APPLICATION FOR: Electrical E]
PROPOSE© INPROVEMENT LOCATION..-
Address:
a "
Legal Description:
Lot No.
1301-111-0001-00015 = \
Property Tax 1 D#• �
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 toe performed under this permit—check a appy:
HVAC Gas Tank Gas Piping _Shutters Windows/Doors
DElectric 0 Plumbing 05prinklers ElGenerator Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ /, d OD • O Utilities:SewerE]Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: JamesVV Law
Address: 8000 S US#1 Suite 402 Company: Law's Bectric, Inc.
City: Port St.Lucie State:FL Address: 218 Beach Avenue
Zip Code: 34952 Fax: City: Port St,Lucie State: FL
Phone Na. 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
7A
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
E'd -89ZL-699-699 Lticc8L8ZLLMb'l d69:80 96 5Z 100
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
PESIGNERIENGINEER: Not Applicable
I __ MORTGAGE COMPANY: k"'Not Applicable
Name: Name:
Address•. Address:
0 . -State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _J/Not Applicable BONDING COMPANY; v-'-Not Applicable
Name: Name:
Address: Address:
City Cita: .
Phone: Zip:_ Phone:
0
CONTRACIrOR AFFIDAff-.Application is hereby made to obtain a permit to do the work and installation as indicated.
I I
that no work or Installation has commenced prior to the issuance of a permit
=E
St Lucie Coun rrmkesno representation that is granting a permit will authorize the permit holderto build the subject structure
Which is in con ict with any applicable Home owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with 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 agreethat I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St-Lucie County Amendments.
Tile following building permit applications are exem
,pt from undergoing a MI concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen room and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in Vour Paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted an the jobsite
before the first inspection. If you intend to obtain financing,consult Villi lender or an attorney before
,ommencing work or recording.your Notice of Commencement.
Sign re of Owner/Agent/Lessee Sig re of Contractor/License Holder
i
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
-he knowledgpd-before me e forgoing instru FThe forgoing-nstru nt was acknowledged before me
lea
.r 20/b thi5'i;L ay of 2&j&-by
(Name of person acknowledging) (Name of person acknowledging)
jjSflgff—atur'&of Notary Public-State of Florida (Sikeat@W of Notary Public-State of Florida
Personally Known ri J OR Produced Identification Personally Known E::— OR Produced Identification
Type of identification Produced Type of Identification Produced
Cloy JULIET LAW gyLIET LAW
Commission No. NOTARY (commission No-E. 9*4 R
Cc'
STATI;: Er
7 Fl. A TARYPUBLICSTATE OF FLORIDA
Revised 07/1512014
Dores 10128M016
res 10r28=16
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW, REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
;COMPLETED
17-d `89Z6-699-499 Lt7CC9L9ZZLMV-1 d69:Co 96 9Z po