HomeMy WebLinkAboutMacTavishALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: JULY 2, 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
Address: 4201 N HIGHWAY AIA
Legal Description: 23 34 40 N 100 FT OF S 1600 FT OF GOV LOT 1 LYG W OF AIA AND A PARCEL MPDAF: FROM A PT
ON WLY RNV LI OF AM (190 FT FVM PT BEING 1500 FT N OF S LI OF GOW LOT 1 RUN S 89 35 30W/TO S U OF GOV LOT 1242.68 FT TO POB
Property Tax ID #: 1423-120-0026-000-9 Lot No. 1
Site Plan Name: Block No.
Project Name:
Setbacks Fron[ Back: Right Side: Left Side:
REPAIR / REPLACE METER CAN WITH DAMAGED LUG.
CONSTRUCTION INFORMATION:
Additional work to y]mormed under tis permit —check all appy:
❑HVAC Gas Tank Das Piping In Shutters Windows/Doors
_ll
I.JElectric E]PlumbingSprinklers ISI Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 800.00 Utilities:In Sewer El Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name CLIFFORD MACTAVISH
Name: THOMAS E RICHMOND
Address: 8247 GREENWOOD PLACE
Company: RICHMOND ELECTRIC, INC
City: NIWOT State: CO
Address: 3086 ENTERPRISE ROAD
City: FORT PIERCE State: FL
Zip Code: 80503 Fax:
Phone No.
Zip Code: 34982 Fax: 772-461-1907
E -Mail:
Phone No. 772-461-1951
Fill in fee simple Title Holder an next page I if different
E -Mail: DEANA@RICHMONDELECTRICINC.COM
State or County License: EC0001458
from the Owner listed above)
If value of construction is $2500 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 Counttyv 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, 1 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
—Signature of Owner%see/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF -wc,C I COUNTY OF er wcle
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this _ day of 20 _by I this _ day of 20 _ by
THOMAS E RICHMOND T OMM E RICHMOND
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public- State
Personally Known x OR Produced Identification _ Personally Known x OR Produced WEntification
Type of Identification Produced Type of Identification Produced
Commission No.
Revised
Commission No. rr
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS