HomeMy WebLinkAboutPermit ApplicationALL APPLICABLE, INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: JANUARY 29, 2018 Permit Number:
r81 RECEIVED
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Building Permit Application .IAN 2 9 1018
Planning and Development Services
Building and Code -Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Count,
Phone: (772) 4624553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IIVII?ROVEM,ENT LOCATION
Address: 2275 BROCKSMITH ROAD
Legal Description: SUBDIVISION OF MC-NURLEN FARMS BLK 2 LOTS 2 AND 3 (18.73 AC)
(OR 3569-862: 3981-1252, 1253)
Property Tax ID #: 2320-501-0018-000-6 Lot No. 2 & 3
Site -.Plan Name: Block No. 2
Proi6ct.Name:
Setbacks, Front Back: Right.Side: Left Side:
DETAILED DESCRIPTION OF WORK
HOOK ELECTRIC. TO GENERATOR
Additional wor.Kto be Dejjrtormea .unoertnis permit —cnecK:a11apply
❑HVAC LJ,Gas Tank Gas Piping. _ Shutters_ a Windows/Doors
Z✓ Electric OPlumbing �Sprinklers �6ene"rotor Roof
Total Sq. Ft of'Coristructio.n: Sq. Ft. -of First Floor:
,00
--Cost of Construction:.$ 2400Utilities: L—(Sewer Septic Building -Height:
OWNER%LES'S EE f°
CONTRACTOR
Name, ROBERT.,& CHANDA NEWMAtJ
Name: CH13I8TOPHER W.RICHMOND
Company:: RICHMOND ELECTRIC,_=
Address: 5410 MYRTLE, DRIVE
City: FORT -`.PIERCE. State: FL
Address: 3086 ENTERPRISE ROAD
Zip..Code: 34982. Fax:
City: FORT PIERCE State: FL
Phone No:
Zip Coder 34982. 1 Fax: 772461-1907
E -Mail:-
Phone No. 772-46171951
Fillin fee simple Title Holder'on next page (if different
E-Mail:,-DEANA@RICHMONDE LECTRICINC.COM
from the Owner, listed: -.above),
State. or County License: EC0001963 .
If value of construction is -52500 on more, a RECORDED: Notice of Commencement,is requires.
SUPPLEMENTAL CONSTRUCTION LIEN` LAW INFORMATION a 4
DESIGNER/ENGINEER:
Name:
:Not Applicable
MbRTGAGE COMPANY:
Name:
_ Not Applicable
Address:
City:
Zip: Phone:
State:
Address:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
Address:
City:
_Not -Applicable
Address:
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.thepermit 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..Wce 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
corhmencing work, -or recording your Notico.of Commencement.
_Signature of Owner Lessee/Agent Signature of Con ractor/License Holder
STATE O.FLORIDA STATE OF -FLORIDA
COUNTY -0,11F sr:LuciE COUNTY'OF sr.wcle
The forgoing.inst-rument was. acknowledged before me The forgoing, instrument was, acknowledged, before me
thiial day of 17d2 I 1 424_, :20IP—by this Z day'of �+'�iit.w a_t �a 120 LEL_ by
CHRISTOPHER W. RICHMOND I CHRISTOPHER -W. RICHMOND
(Name of person acknowledging ). (Name ofperson acknowledging.)
Notary Public= State of,Fl, da ); (Signature of NotaryPublic- State of
,Personally Known X OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced . Type ofadentification Produced
Commission No. FF:� Commission No.. Ft sasos9
o`P`Y noo` Notary,
Public State of Flonda' `
R o Deana.M Dalley
o+►'r xu� Notary Public -State of Florida
c Q" My Comm ssion q
? o� - Ex inss 0811y2019 y �, -My Commission FF 909099
Revised 07/15/20 g:< w� 'd Expires08H2/2010 "
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