HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -T-41q- F -zip Permit Number:
R E C E I V":D ]AN 2 7017
Building Permit Application'
Planning and Develaiiinent Services
SuffdIng and Code Regulation DWslon
2300 11irginio Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)4621578 Commercial Residential X
PERMIT APPLICATION FOR: Bectritcal
:PROPOSED INPROVEMENT LOCATION.:',
Address:
:Legal Description:
-property Tax ID#: 3414-501-1701-000/9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORM:
Replace meter center with a combo pack
CONSTRUCTION INFORMATION.'
Additionalworictob(ewe( orme d under this permit-checK all ttla apply:
IHVAC LJ Gas Tank F❑las Piping ElShutters Windows/Doors
EElectric Plumbing E]Sprinklers 11 Generator Roof
Total Sq.Ft of Construction: 11 Sa.Ft of First Floor:
Cost of Construction: Utilities:[]Sewer r]Septic Building Height:
OWNERAESSEE: CONTRACTOR-.
Name Wynne Building Corp. Name: James W Law
Address: 8000 S US#I Suits 402 Company: Law's Electric, Inc.
City- Port St.Lucie State: Fl- Address: 218 Beach Avenue
Zip Code: M52 Fax: City: Port St.Lucie State.- FL
Phone No. 772-878-5513 Zip Code: 34952 — Fax: 772-878-3347 1
E-Mail: Phone No. 772-971-4512
Fill in fee silmple'ritle Holder on next page if different E-Mail: lawselectric7inc@aol.com
from the Owner listed above) State or County License: ER0000122
lf,value of construction is$2S00 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNERIENGINEER: V Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
Gty: State: City: State:
Zp: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: .!/Not Applicable BONDING COMPANY: Not Applicable
Name. Name:
Address: Address:
city: may-
Zip: Phone: ZIP: Phone:
I certify that no work or installation has commenced priorto the issuance of a permit.
St.Lucie Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in corcfilet 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 ofthe 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 Lode county Amendments.
The following building permit applications are exemptfrom undergoing a full concurrency review:room addictions,
accessory structures,swimming pools,fences,wails,signs,screen rooms and accessory uses to another non-residentlal use
WARNING TO OWNER:Yourfailure to Record a Notice of Commencement may result in your praying 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
Si re of owner/Agent/lessee Si ofContractor/Ucense Holder
STATE OF FLORIDA STATE OF FLORIDA
'COUNTY SAINT LUCIE COUNTY OF SAINT LUCIE,..
Thefor�I g instrur- *was acknowledged before me The fo� g i gA;was acknowledged before me
this -Jay of 20?-by this��ay of 204&-by
.TAMES W LAW 4 JAMES W LAW
(Nam person acknowledging) (iMa of person acknowledging)'
i'l� &IIA= o 46 .
(Signatum of Notary Public State of Florida) (Signature of Notary Public-State of Florida 1
Personally Known_ 1�OR Produced Identification Personally Known V-***- OR Produced Identification
Type of Identificatiop I!mduced Type of Iden0cation Produced
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Commission No MY I�SI�N�if�F°-
FIRES Apn121,2020 ANNE BFXMq
(407)39MI53FbtwaNda �rvM�tarn
eV]Sea 07/1$/2014 MY COMMIISSION#FFSM63
„o EXPIRes April 21,2020
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REVIEWS FRONT ZONIAiG SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
GATE
COMPLETE
INITIALS
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