HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/5/2017 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
Address: 2510 GRAY TWIG LANE
Legal Description: TWELVE OAKS ESTATES LOT 6 (0.31 AC) (OR 3672-1568)
Property Tax lD #: 3405-801-0006-000.3
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Lot No. 6
Block No.
REPLACE EXISTING 200 AMP SINGLE PHASE ELECTRICAL PANEL. LIKE FOR LIKE.
I CONSTRUCTION INFORMATION: III
❑�IHVAC Li Gas Tank
ZElectric El Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1,46700
Piping UShutters Windows/Doors
nklers 11 Generator Roof
S Ft. of First Floor: _
Utilities:
Sewer ElSeptic
Building Height-
OWNER/LESSEE:
CONTRACTOR:
Name WILLIAM S KATHLEEN DAVENPORT
Name: CHRISTOPHER W RICHMOND
Address: 2510 GRAY TWIG LANE
Company: RICHMOND ELECTRIC, INC
City_ FORT PIERCE State: FL
Zip Code: 34981 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
If value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
FRONT
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
MANGROVE
Address:
COUNTER
City:
Zip: Phone:
State: _
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
Not Applicable
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 Counj 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 jobs ite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
`"N / - 9 �/lityl LI/ �J� s
_Signature of Owner/ Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF sr. wore
The fcZing instrument was acknowledged before me
this day of,bACe4" �! 2011 by
(signature of Notary Public - State Vlorida I
Personally Known x OR Produced Identification _
Type of Identification Produced
Commission No. FF eos
Notary Publlc Suieof Fbllad
Revised
STATE OF FLORIDA
COUNTY OF sr. ---
The forgoing instrument was acknowledged before me
this,rday of lrP., Ay -w 20 /Tby
CHRISTOPHER W RICHMOND
(Name of person acknowledging I
(Signature of Notary Public - State of Flo lol
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. FF
OF .
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS