HomeMy WebLinkAboutBuilding Permit Application i
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �J Permit Number:a/J
ECEIVE
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Planning and OevelopmentServices Building Permit Application JAN 7 2017 `
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial , ential X
PERMITAPPLfCATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID#: 3414-501-1701-000/9 Lot No.
Site Plan Name: Block No.
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Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo pack at each address
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CONSTRUCTION INFORMATION:
AddMonal work to be Derrormed under ispermrt— eck a appy:
HVAC i 11 n Gas Tank ❑Gas Piping Shutters I]Windows/Doors
CGenerator
a Electric 0 Plumbing Sprinklers ❑Roof
Total Sq.Ft of Construction: Sq.Ft of First Floor:
Cost of Construction:$ e � Utilities'
Sewer USeptic Building Height.-
OWNER/LESSEE:
eight:OWNER/LESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Law
Address: 80001S 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 No. 772-878-5513 Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No. 772-971-4512
aol.com
Fill in fee simple Ttle Holder on next page{if dl'ifFerent E-Mail: lawselectricinc @
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: 4
City: I State: City: State:
Zip: 1 r
Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: I/-Not Applicable BONDING COMPANY: , Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: L Phone: Zip: Phone:
I certify that no work or installation has commenced.prior to the issuance of a penniL
St Lucie_Coun�makes no representatwn that is granting a permit will authorize theermit holder to build the subjectstructure
which is in oorrliict with any appfigbfe Home Owners AssocEatron rules,bylaws or angcovenants that may restrict or prohibit such
structure Please consult wcth your Home Owners Association and review your deed for any restrictions which may apply.
Inconsideration ofthe granting ofthis requested permit!do hereby agreethat I will,in all respects,perform the work
in accordance with t e approved 101ans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit appligtions are exemptfrom undergoing a full concurrency review:room additions,
accessory structures swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
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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 attomey before
commencin worst or recording our Notice of Commencement.
Si re of owner/Agent/Lessee 5 ature of Contractor/License Holder
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STATE OF FLORIDA - STATE OF FLORIDA
'COUNTY OF SAINT LLICIE COUNTY OF SAINT LUCIE
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Theforgoing instrumentwas acknowledged before me The forgoing instrument was acknowledged before me
this /7 day of gam_ . 2022—by this l' day of :774-OL .20 J by
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.,ZANIES W LAW
JAMES W LAW
(Name of person admowledging) (Name of person acknowledging)
- J i_i V Lwv-, 13rot-t V v
( nature of Notary Public State of Florida) (Signature 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. (Seal) Commission No. _ (Seal)'
ANNE BROW
'e MY COMMISSION#FF984663f. My COMMISSION*FFOU663
Revised 137/15/2414 rar:r es uas3 EXPIRES APAI 211 2o20 EXPIRES April 21.2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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