HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5-29-18 Permit Number:
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
1300 VirginioAvenue, Fort Pierce FL 34981
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_ P EMENTL
Address: 9529 SHADOW LANE
Legal Description: MONTE CARLO COUNTRY CLUB - UNIT TWO -LOT 216 (OR 4006-124)
Property Tax ID R: 1334502-0097-0008 Lot No. 216
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
HOOK TRANSFER SWITCH AND GENERATOR TO EXISTING SINGLE PHASE 200A SERVICE.
CONSTRUCTION INFORMATION:
c
Auditional work to e e orme un ert is permit — c eca appy:
❑HVAC Gas Tank []Gas Piping _ Shutters Windows/Doors
ZElectric 0 Plumbing Sprinklers
Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cast of Construction: $ 2350.00 UtilitiesSewer ❑Septic Building Height:
:.OWNER/_..
CONTRACTOR:
Name DANA JUILLERAT
Name: CHRISTOPHER W. RICHMOND
Address: 9529 SHADOW LANE
Company: RICHMOND ELECTRIC, INC
City. FORT PIERCE State: FL
Address: 3086 ENTERPRISE ROAD
Zip Code: 34851 Fax:
City: FORT PIERCE State: FL
Phone No.
Zip Code: 34982 Fax: 772-461-1907
E -Mail:
Phone No. 772-461-1951
Fill in fee simple Title Holder on next page ( if different
E -Mail: DEANA@RICHMONDELECTRICINC.COM
from the Owner listed above)
State or County License: EC0001963
N value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: II
-w =1•s•il.ccn: _VICE Nppucame MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State:_ City: State:
Zip: Phone: Zip: Phone:
Name:
Address:
City: _
Zip:_
HOLDER: _Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
build
------.--.------•••---••_� �uupawa or anu covenanu [not may restrict Or prohibit such
structure. Please consult with your Hame 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
COntmenrino wnrk nr iu. H......1 r________
Revised 07/15/2014
REVIEWS
FRONT
ZONING
SUPERVISOR
Signature of0 ner/Lessee/Agent
Signature ofC trail/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 9r., -,P
COUNTY OF ST were
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 2j day of j%n] 20 LLby
this L 9 day ofbA_ 20 J&_ by
CHRISTOPHER w RICHMOND
CHRISTOPHER IN RICHMOND
(Name of person acknowledging)
(Name of person acknowledging )
I t� ado E y
s 1 K• Q, ra
(Signature of Notary Public -State lorida)
(Signature of Notary Public-Sta[e of Flor )
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
_
Type of Identification Produ l
fUM� Ndery ea
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Commission No. FFW Dean:M15e1MFF909099
Commission No. IF 909099 "+�,;e,H t�yy�a�SmredPwlae
nary Expires 00/1212019
• _ """^"'^'kY ___
Revised 07/15/2014
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS