HomeMy WebLinkAboutBuilding Permit Application I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: W �`d/(o Permit Number'
i
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 j
Phone.(772)462-1553. Fax: (772)452-1578 Commercial ! ResiderEtial X
PERMIT APPLICATION FOR: Electrical 0
PROPOSED INPROUEM ENT LOCATION:
Address:
f
Legal Description: !
Property Tax ID#: 130, 111-0001-Q001� j Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Lefts de:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
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CONSTRUCTION INFORMATION:
Additional wor to Frormed unclertHis permit—check all t=appy:
1]HUAC L_i Gas Tank ElGas Piping _Shutters) E]Windows/Doors .
L`"rlElectric Plumbing SprinklersGenerator �Roof
Total Sq.Ft of Construction: SQ. Ft.of First Floor:
Cost of Construction:$ / 4�I��- Oda
Utilities: Sewer Septic Building i-)eight:.
OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp_ Name: .tarries W Law
Address: 8000 S US#1 Suite 402 Company: LaW's Electric, Inc:j
City: Port St Lucie State: FL Address: 2181 Beach Avenue"
Zip Code: 34952 Fax: City; Port St_Lucie j 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 iLicense: ER0000122
if value of construction is$2500 or more,a RECORDED Notice of Commencement&'required
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SUPPLEMENTAL CONSTRUC11ON LIEN LAW INFORMATION:
DESIGNERIENGINEER: V Not Applicable MORTGAGE COMPANY: VNotAppiicable
Name: Name-
Address: Address: `
City: State: City: State:
TI Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _L/_Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: city:
Zip: Phone: Zip: Phone:
I certify that no work orinstallation has commenced priorto the issuance of a permit.!
5t Luae County makes no representation that is granting apermit will authorize the permit holderta build the subject structure
which is in conflict with amr applicable Home Owners Association rules,bylaws or antcovenants that may restrict or prohibit such
structure.Please consult w 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.
The following building perrnFt applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,wails,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.
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Sign re of Owner/Agent/Lessee gnature of Contractor/License Hoiden
STATE OF FLORIDA STATE OF FLORIDA
•COUNTYOF SAINT WCIE COUNTY OF SAINT WCIE..
The farvning inshumentwas acknowledged before me The forgoing instrument was acknowledged before me
this�day of,r�(�V.,• . 2a Z6by this Lslay of pQa li 20,[.-by
JAMES W LAW .LAMES W LAW
(Na of pers
on acknow ging) (Name eperson acknowledging)•'
.(Signature of Notary Public-State of Florida) (5i afore of Notary Public-State of Florida)
;Personally Known V-"OR Produced Identification Personally Known A�`IOR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Ell-- (Sea[) Commission No. !OZ FAA ,6a 3 (Seal).
+!'' ANNE BROWN W MACH
r ' •5 My COMMISSION#FF9W63 UKOWN WALMACH
Revised 07MI2014 '..,, EXPIRES A el 21,2020 ;; MY COMMISSION#FPFgggg63
(107 app-0153 FlorldnNom ��:,•• , EXPIRE$
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
:DATE
-COMPLETE !
INITIALS
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