HomeMy WebLinkAboutBuilding Permit Application y.
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
DPermit Number-' ,oZ,-
Building Permit Application
Planning and Development Services
Building and Code Regulation Division i
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553. Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address•
Legal Description:
Property Tax ID#: 1309-111-0001-00010 Lot No.
Site Plan Name: Block No.
Project Name:
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Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION OF WORK: . i
Replace meter center with a combo pack,
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CONSTRUCTION INFORMATION: i
Additional work toe nertormed under tis permit—check a appy: 1
FHVAC Gas Tank ❑Gas Piping _Shutters "Windows/Doors
Electric Plumbing Sprinklers 0 Generator FIRoof
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Total Sq. Ft of Construction: 5 Ft.of First Floor: I
Cost of Construction:$ c`—dC�,�d _ _ utilities.0Sewer llseptiguilding Height:
OWNERAESSEE: CONTRACTOR: .
Name Wynne Building Corp. Name: James W'L'aw
Address: 8000 S US#1 Suite 402 Company: Law's Electric, Iric.
City: Fort St.Lucie State: FL Address: 218 Beach Avenue
Zip Code: 34952 Fax: City: Port St. Lucie State* FL
Phone No. 772-B78-5513 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No.. 772-971-4512 .i
Fill in fee simple Title Holder on next page(if different . E-Mail: lawselectiicinc@aol.com
from the Owner listed above) State or County License: ER0000122 .
If value of construction is$2500 or more,a RECORDED Notice of Commencementis required,
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DE SIG NERJEKGINEEIt: i!Not Applicable MORTGAGE COMPANY: NotAppticable
Name: Name:
Address- Address:
pty: State: City. State:
pp: Phone: Zip: Phone:
kE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY- ; Not Applicable
Name: Name:
AddreSs: Address: 1
city: City:
Zip: -- Phone: Zip: Phone:
I certify that no woric or installation has commenced prior to the Issuance of a permit,
St Lucre Coin makes no represerMation that is granting a permit will autthorae 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 agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St Wcie County Amendments.
The fallowing building permit 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 jobs'Ite
before the first inspection.if you intend to obtain financing,consult with lender or an attorney before
comment` worts or recording urNotice of Commencement,
Sign re of Owner)Agent/Lessee S tore of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA '
-COUNTV OF SAINT WaE COUNTY OF SAINT i:UCIE,..
The forgoing instrument was acknowledged before me Theforeoing� was acknowledged before me
this,„day of E � Z;�. , x4�by this day of _'�'LL. by
JAMES W LAW JAMES W!LAW ,
IN am person acknowledging) (Na of person acknowledging)' ,'
(Signature of Notary Public-State of Florida) (Signature of Notary Public State of Florida)
Personally Known- -Y- iifiation Personally Known , y ' OR Producedidentification
"t"ype of Identification Produced
Type of Identification Produced
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AN RO�rWr1r�NNAI +�IACtt
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PIRES April 21,202x1 ., .,
7I 4 FrorkhNt
Revised 07115/2014 MY COMMISSION#FF98d863
�" EXPIRES A*121,2020
REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETAnoN SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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