HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/29/17 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
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: 2418 ATLANTIC BEACH BLVD
Legal Description: FORT PIERCE SHORES - UNIT 1 - BLK 2SLY 2 FT LOT 6 AND ALL LOT 7 (OR 801-864)
Property Tax ID #: 1436-601-0029-000-6 Lot No. 6 & 7
Site Plan Name: Block No. 2SLY
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: I
REPLACING RISER WIRE AND WEATHERHEAD ON EXISTING SERVICE.
Haaitional work to bene] rtormed
11 HVAC L.._J Gas Tank
Electric ❑ Plumbing
under this permit — check
[]Gas Piping
Sprinklers
a appy:
�_ Shutters
In Generator
� Windows/Doors
❑ Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 671.00
Utilities:cnSewer
SFt. of First Floor:
Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name HUBERT & MAUREEN MELVIN
Name: CHRISTOPHER W. RICHMOND
Address: 2418 ATLANTIC BEACH BLVD
Company: RICHMOND ELECTRIC, INC
City: FORT PIERCE State: FL
Zip Code: 34949 Fax:
Phone No.
Address: 3086 ENTERPRISE ROAD
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-461-1907
Phone No. 772-461-1951
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: DEANA@RICHMONDELECTRICINC.COM
State or County License: EC0001963
1� PZ�UU U< nwre, d Rcwrcucu rvouce or commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 County 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 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 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
commencing work or recording your Notice of Commencement.
_ Signature of Owner/ Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The forgoing instrument was acknowledged before me
this day of �e 20 Ll by
CHRISTOPHER W RICHMOND
(Name of person acknowledging )
(Signature of Notary Public- State of Flo
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. FF
Notary Public State of Florida
Deana M Dailev
Form Expires 08/12/2019
Revised 07/15/2(
STATE OF FLORIDA
COUNTY OF ST LUCRE
The forgoing instrument was acknowledged before me
this day of '�9�b01t 20 L_T by
CHRISTOPHER W. RICHMOND
(Name of person acknowledging )
k -1a�i?� �
(Signature of Notary Public- State of FI
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. FF 90909 00P Notary Keakil�tate of Florida
r ♦ Deana M Dailey
o My Commission FF 909099
of F%
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