HomeMy WebLinkAboutBuilding Permit Application ALL APP CABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: /to
Building Permit Application RECEIVED
Planning and DeveiopmentServices I�OV 201
Building and Code Regulation Division G
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)452-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical E
PROPOSED INPROVEMENT LOCATION.-.-
Address:
Legal Description:
PropertyTax ID#: 1301-111-0001-00015 ?L 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:
Additional work toe nerformed unclert is permit—c e a apply:
aHVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
aElectric El Plumbing Sprinklers E]Generator O Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ C)� Oy Utilities- 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 Lucie State: FL Address: 218 Beach Avenue
Zip Code: 34952 Fax: City: Port St.Lucie State: Fl-
Phone
LPhone 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: ER0000122
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ✓ Not Applicable MORTGAGE COMPANY: ✓Not Applicable
Name: Name:
Address: Address:
City: State: City: $tate-
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: �Not Applicable BONDING COMPANY:
Not Applicable
Name.
Name:
Address: Address:
City: City:
Zip: Phone- Tip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit
St Lucie County makes no representation that is granting a permitwill 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 vMh 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 Lude County Amendments.
The following building permit applications are exempt from undergoing a fib 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
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
commencinu work or recording our Notice of Commencement.
Si re of Owner/Agent)Lessee Ognature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINT LUCIE COUNTY OF SAINT LUCIE. .
The forgoing instruipent was acknowledged before me The forgoing instrur ent was acknowledged before me
this day of 20 Eby thisday of ? .Zp.ej& by
,JAMES W LAW JAMES W LAW
( e ofperson acknowledging) (N of person acknowledging)-
4 &, �,L-- -- 8r.0 n.,,- -
(Signature of Notary Public-State of Florida) ( ignature of Notary Public State of Florida)
Personally Known ✓ OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No_ fF� ��3 Commnrssion No__.�f y����., (Seal)'
4• M ANNE BRO WALMACH
N q.2o2a g3 MY CbMMISSlaN!�FF684883
Revised 07115/2014 r,fliiPIREs qp,�l 21, a
F 3!„ EXPIRES April 21.2o2o
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REVIEWS FRONT ZONING SUPERVISOR PI.ANS VEGETATION S1:ATURTIE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW .
DATE
COMPLETE
INITIALS
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