HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/20/17 Permit Number:
• Building Permit Application
Planning and Development services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION ''
Address: 420 DAKOTA WAY
Legal Description: 33 34 40 SE 1/4 OF NW 1/4 LESS NIDD FT LYG E OF E RM/ CHEROKEE AV EXTENDED SOUTHWARD AND LESS
E 100 FT - AND FROM CENTER OF SEC AT PT ON E SIDE OF CANAL RUN S 88 DEG 33 MIN 54 SEC W ALG E-W 1/4 SEC LI 329.9
Property Tax ID tt: 1433-210-0003-000-9 Lot No.
Site Plan Name: TALL PINES MOBILE HOME PARK Block No.
Project Name: 321 S. ERIE DRIVE
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALL GFI PROTECTION, CLEAN UP EXISTING OPEN WIRING AROUND UNIT, RESECURE
LOOSE BOXES AND DEVICES.
CONSTRUCTION INFORMATION:
FF�""itjjlona Wor IO e e orme under tIs permit —c ec a appy:
O�IHVAC 1iGas Tank E]Gas Piping _shutters
Windows/Doors
ZElectric ElPlumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S. of First Floor:
Cost of Construction:$ 1,013.00 Utilities: Sewer E]Septic Building Height:
Name K ANDD AFFILIATES Name: CHRISTOPHER W. RICHMOND
Address: 314 S ERIE DRIVE Company: RICHMOND ELECTRIC, INC
City: FORT PIERCE State: FL Address: 3086 ENTERPRISE ROAD
Zip Code: 34946 Fax: City: FORT PIERCE State: FL
Phone No. Zip Code: 34982 Fax: 772461-1907
E-Mail: Phone No. 772-461-1951
Fill in fee simple Title Holder on next page ( if different E-Mail: DEANA@RICHMONDELECTRICINC.COM
from the Owner listed above) State or County License: EC0001963
If value of construction is $2500 ar more, a RECORDED Notice of Commencement is required.
SUPPLEMENTALCONSTRUCI-IONLIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State:_ City: State:
Zip: Phone: Zip: Phone:
IIFEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable II
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count% makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or antl 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. Lucie County Amendments.
The following building 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
`I ti w
_ Signature of Ow er/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF ST. wclE
The forgoing instrument was acknowledged before me
this20 day-"Apc 201 by
CHRISTOPHER W. RICHMOND
(Name of person acknov
Signature of Contractor/Ucense Holder
STATE OF FLORIDA
COUNTY OF sr WDE
The forgoing instrument was acknowledged before me
this22a dayofAlrl .20 L -T by
CHRISTOPHER W. RICHMOND
(Name of person acknowledging)
Personally Known x OR Produced Identification _ Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Prs
Revised
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