HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
111111FRI1111M
RECEIV7D JAN 2 '7Z017
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
.23CO Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)452-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION.:'
Address:
Legal Description:
Prop"Tax IOM 3414-501-1701-000/9 Lot No.
Site Plan Name: Black No.
Project Name:
Setbacks Front Back:_Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter center with a combo packA.�� '466
CONSTRUCTION INFORMATION: I
Additional work to bneerformed under this permit—check al I that apply:
F1
1 Gas Piping 7 Windows/Doors
HVAC Gas Tank _Shutters
PlElectric Plumbing FSprinklers Generator Roof
Total Sq.Ft of Construction: S Ft. f First Floor:
Cost of Construction: Sewer EiSeptic Building Height:
Utilities:
OWNER/ ESSEE: CONTRACTOR:
Name Wynne Building Corp. Name: James W Low
Address: 8000 S US 41 Suite 402 Company: Law's Electric,Inc.
City: Port St.Lucie State;FL Address: 218 Beach Avenue
Zip Code: 349:52 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
Fill in fee slimple"Title Holder on next page if different E-Mail: lawselectricinc@aol.com
from the Owner listed above) State or County License: ER0000122
I I
If value of construction is$2500 or more,a RECORDED Notice of Commencement Is required. . I
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ✓ Not Applicable MORTGAGE COMPANY: ✓Not Applicable
Name: Name-
Address: Address: `
City: State: City: —State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _L/ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Trp: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit
St.Lucie Counttyy makes no representation that is granting a permit wit[authorize the permit holder to build the subject structure
which is in oorrflid with any applicable Home Qwners{association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please mnsuft with your Home Owners Assoc]ation and review your deed forany restrictions witch may apply.
in consideration ofthe granting ofthis 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 Lude County Amendments.
Thefollowing building permit applications 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
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying t+Ute 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
commencing work or recording our Notice of Comm cement,
Sign re of Owner)Agent/Lessee Si re of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
'COUNTVOF SAINT WCIE COUNTY OF SAINT LUCIE. .
The forgo] g instrur.n�was acknowledged before me The forNgoi g In �was acknowledged before me
thls�day of ) 20Z:by this ay of 20 by
.DAMES W LAW JAMES W LAW
(Nam person acknowledging) (Naof person ac(mowledging)
AIL l�v� 4k� A" G�cel
(Signature of Notary Public State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known��OR Produced Identsfication
Type of Identification Qroduced Type of Identification Produced
No.f� :��+'' ANN ROWN YpVA�VIACH
.
Commission _.f 3 {Seal) _ •-= MY C I�S�O�Il:FF
a, FIRES Agri!21,200
163 Fb�lo�N Hwe..ea» t
Revised 07/15/2014 MY COMMISSION#FP984663
EXPIRES April 21,2G20
_
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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