HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date- Permit Number:
REC.EIVED AUG 15 2017
Building Permit Application
Planning and Development Services
suilding and Code Regulation Division
2300 Virginia Avenue,Fort Xerce FL 34982
Phone:(772)462-1553462-1578 Commercial x Residential
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Address: 208 ROUSE ROAD
Legal Description: 16 34 40 FROM SW OR RUN N ALG WSEC LI 445 FT,TH S 88 DEG 40 MINE 33OFT FOR POB,TH
CONT ON SAMEBEARING WOFT.TH N 01 OW 20 MIN E 678 FT.TH N 08 DEG 40 MIN W=Fr,TH 8 01 DEG 20 MIN W 575 FT TQ POO(T.aO AC)(QR 3760404'.;378"90)
PropertyTaxID#: 1416-331-0015-000-5 Lot No,
Site Plan Name; Block No.
Project Name:
Setbacks Front;_ Back:_Right Side: Left side:
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INSTALL ONE OVERHEAD TEMPORARY POWER POLE (SINGLE PHASE, 100A, 120/24OV)
NEI�1.011
cK a ap 1ly,
■ S"utters wndows/Doors
e c Ing pri Generator Roof
Total Sq.Ft of Construction: Sq.Ft,of First Floor-
Cost of Construction:$ 1135.00 Utilities:0Sewer ED Septic Building Height:
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CHRISTOPHER W.RICHMOND
Name.
1#6 Company: RICHMOND ELECTRIC,INC
Address: 3086 ENTERPRISE ROAD
City. FORT PIERCE State;FL
71p Code: 34982 Fax: 772-461-1907.
-461-1951
Phone No. 772
DEANAQRICHMONDELECTRICINC.COM
Ellwt% I E-Mail:
State or County License: ECOOD1963
DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip.'_Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
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.Lucle Counmake9 no representation that is granting a HAermit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Associatlon rules,bylaws or and covenants that may restrict or pro ibit 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
commencin work or recording our Notice of Commencement.
_Signature of O er/Lessee/Agent Signature of Contrador)License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF_aT,Lvice COUNTY OF sLLUCIE
The forgging instru ent was acknowledged before me The forgoing instrument was acknowledged before me
this day of r 20,Zby this day of hk6o4g rl- 20/7 by
CHRISTOPHER W.RICHMOND CHRISTOPHER W.RICHMOND
(Nameof person acknowledging) (Name of person acknowledging)
. r
(Signature of Notary Public-State of Florida'el (Signature of Notary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF9osos Commission No. F15209099 )
Notauy Public 6tata�Fwu Notary public state or 1=
trema M Dailey
Revised07/15/2414 % ~df Explrcaos/1?!2°7s �b. my meoaieyiois9�a�
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS