HomeMy WebLinkAboutBuilding Permit Application I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED;
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Date:a��*j),/ f o2� Permit Number: O � '
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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: A 5o`�.5
Legal Description:
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130 111-0001-000!e
Property Tax lD#: 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 .
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CONSTRUCTION INFORMATION:
Adclitionalworictobe ertarmed under this permit–c ec a appy:
HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
Lr J Electric I Plumbing 05prinklers 1:1 Generator EIRoof
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Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ z1:1 Utilities:L_1 Sewer F-1 Septic Buifding Height:
OWN ERAESSEE: CONTRACTOR:
Name Wynne Building Corp-
Name: James W Law '
Address: 8000 S US#1 Suite 402 Company: Law's Electric, Inc.
Port St.Lucie FL 218 Beach Avenue
City: State:� Address:
Zip Code: 34952 Fax: City: Port St_Lucie IState: FL,
Phone No. 772-878-5513 Zip Code: 34952 '1 Fax- 772-878-3347
E-Mail: Phone No. 1772-571-4512
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: 480000122
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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: i ✓ Not Applicable
Name: Name:
Address: Address: `
City: State: City: I State:
Zip: Drone: Zip: Phone:
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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
SL Lucie County makes no representation that is granting a permit will authorize the perrnit 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 wrth 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 SuHding Codes and St:Lucie CountyAmendments.
The following burilding 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.
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Signa re of owner/Agent/Lessee Oignature of Contractor/License Hblder
STATE OF FLORIDA STATE OF FLORIDA
COUNTl�OF SAINT LUCIE COUNTY OF SAINT LU.CIE..
The fr loing instrV was acknWedged before me The foraging lnstrument was acknowledged before me
byth"� day of 20.j�7—by
JAMES W LAW JAMES W LAIN
(Na person acknow ging) (Name person acknowledging)j
(Signature of Notary Public-State of Florida] (Sibiature of Notary Publio-State of Florida)
Personally Known Y OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No-_ (Seal) Commission No._ff 1�� tri I L-3 (Seal}
ANNE BROWN WALMACH
MY COMMISSION 0 FFN4663 .;;'I WN WALMACH
Revised 07/15/2014 '. EXPIRES April 21,2020 MY COMMISSION#FF984"3
(407)39"M FbAdaHote �!...... EXPIRBS
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REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEA TURTLE2MMOVE—
COUNTER REVIEW REVIEW REVIEW REVIEW j REVIEW REVIEW
DATE
COMPLETE
INITIALS
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