HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �J
Date: Uel 10 l� Permit Number \<.121-00 1
RECEIVED DEC 0 0 2016
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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
PROPOSED iNPROVEMENT LOCATION:
Address: /
Legal Description:
PropertyTax ID#• 130,6,111-0004-0001a Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
i
Replace meter center with a combo pack
CONSTRUCTION INFORMATION:
itiona wor to e e orme under this permit—check all a=appy:
DHVAC Gas Tank ❑Gas Piping _Shutters ElWindows/Doors
L!Electric 0 Plumbing Sprinklers a Generator Roof
Total Sq.Ft of Construction: 5 Ft.of First Floor:
Cost of Construction:$_ ��G�, G� Utilities:Sewer 11 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp_ Name: James W Law
Address: 8000 S US#1 Suite 402Company: 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 No. 772-878-5513 Zip Code: 34852 Fax: 772-878-3347
E-mail: Phone No- 772-971-4512
Fill in flee simple Title Halder on next page(if different E-Mail: lawselectricinc@aol.com
from the Owner listed above) State or County License: ERCOOD122
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: V Not Applicable MORTGAGE COMPANY: -%/—Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: .j Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced.prior to the issuance of a permit
5Lucie County mattes 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 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 l will,In all respects,perform the work
in accordance with the approved plansy 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
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 our Notice of Commencement
Sign re of Owner/Agent/Lessee 01griature of ContractodUcense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINT WCIE COUNTY OF SAINT LUCIE,
The forgoing Instrkiment was acknowledged before me The foraging instrument was acknowledged before me
Ili ,day of .�(}yd _ 20 Eby this.qday of ✓gyp r' .z0� by
JAMES W LAW JAMES W LAW
(Na person ackno ging) (Name person acknowledging)
(Signature of Notary Public-State of Florida} (5' ature of Notary Public-State of Florida)
Personally Known Y OR Produced Identification Personally Known OR Produced Identification
Type of Identifications Produced Type of Identification Produced
Commission No. (Seal) Commission No. F Fw k (.z3
ANNE BROWN WALmAcH
i MY COMMISSION#FFSBM3 I=bKOWN WALMACH
Revised 09115/2014 EXPIRES Apol 21,2020 �� = MY COMMISSION#FF984883
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RafflamphrAiceown EXPIRES
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE
fWANGIOVEr-
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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