HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/19/2018 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
LPROPOSED IMPROVEMENT LOCATION:
Address: 787 NETTLES BLVD
Legal Description: NETTLES ISLAND INC, A CONDO - SECTION fl PARCEL 787 AND PRO -RATA SHARE IN COMMON
ELEMENTS (OR 2574-2386)
Property Tax ID It: 4502-501-0973-000-2
Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: LeftSide:
DETAILED DESCRIPTION OF WORK:
INSTALL NEW 4 WIRE DRYER RECEPTACLE INCLUDING 10 GAUGE WIRE FROM
ELECTRICAL PANEL.
'CONSTRUCTION INFORMATION:
Additional work to ne eroorme on ert is permit—"ec a appy:
❑HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
0✓
Electric Plumbing Sprinklers 11 Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction :$ 778.00 Utilities:CnSewer❑septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name MICHAEL CERULLO
Name: CHRISTOPHER W. RICHMOND
Address: 163 ACRE LANE
Com an RICHMOND ELECTRIC, INC
Company:
Y
City: HICKSVILLE State: NY
Address: 3086 ENTERPRISE ROAD
Zip Code: 11801 Fax:
City: FORT PIERCE State: FL
Phone No. 516-581-2607
Zip Code: 34982 Fax: 772-461-1907
E -Mail:
Phone No. 772-461-1951
Fill in fee simple Title Holder on next page I if different
E -Mail: DEANAGRICHMONDELECTRICINC.COM
from the Owner listed above)
State or County License: EC0001963
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: II
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
ZIP: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Name:
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
no
the
_Not Applicable
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
commencine work nr rnrnrdinn ,a, ld +; -f r....,.,...______.
_ Signature of Owner/ Lessee/Agent Signature of Contractor/L¢ense Holder
STATE OF FLORIDA
COUNTY OF eT waa
The far oing instrument was acknowledged before me
this[ dayof 20/3—by
STATE OF FLORIDA
COUNTY OF Sr. was
The for oing Instrument was acknowledged before me
this day ofj"I A 20 &_ by
CHRISTOPHER W RICHMOND
FRONT
CHRISTOPHER W RICHMOND
(Name of person acknowledging)
PLANS
(Name of person acknowledging )
L[ Aljb
�
I
(Signature of Notary Public -State of Flopa )
REVIEW
(Signature of Notary Public -State of Flovpb)
Personally Known x OR Produced Identification _
REVIEW
Personally Known x OR Produced Identification
Type of Identification Produced
_
Type of Identification Produced
Commission No.
Revised
Commission No. rr
Notary 1
Deana
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
OATS
COMPLETE
INITIALS