HomeMy WebLinkAbout18110491 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/27/2018 Permit Number: 11 U 9
. MINIMUM 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 X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
/, ,, ,,, ,, ;
"" "i-. ", 4., .. / .�/ /�� i / /✓///// �1 / / /�,� a /�j v //'/�/,,.
PR�PQSEQ INROVEM1=
Address: 3100 St. Lucie Blvd
Legal Description: San Lucie Plaza S/D-Unit one- Blk 62 Lots 1, 2, 3,4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18
19, 20,21, 22, 23, 24, 25,26, 27, 28, 29, 30, 31, 32, 33, 34, 35 and 36 (Map 14/29S) (or 297-1516)
Property Tax ID#: 1428-702-1420-000-9 Lot No.
Site Plan Name: House behind church Block No. 62
Project Name: Northside Worship Center
Setbacks Front Back: Right Side: Left Side:
r H,
i, i r
DETA[lED QES/RIPT[O 'OF�WORK /%� ///
„/
// ,,_„/x%,. / ,o,!✓/ii.,,.✓y:. ,.i,,,. ,i:
Replace existing meter can. Like for Like.
CONST,RUCTh ,. IN[ O:R;..�T(.ON / s
Additionalwork toe e orme under this permit-check a appy:
HVAC 11 Gas Tank OGas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 600.00 Utilities:n Sewer Septic Building Height:
0,
30e .. !/i. TRI�C„TrOi,����/i�/�D/��J y !✓;�%��/d/
v1Rt /MECO
Name' Northside Worship Center Inc. Name: CHRISTOPHER W. RICHMOND
Address: 3100 St. Lucie Blvd Company: RICHMOND ELECTRIC, INC
City: Fort Pierce State: FL Address: 3086 ENTERPRISE ROAD'
Zip Code: 34946 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
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
,.,, .o ci//%/ice t/..i. z,////O/%%/%L%/L/a /, r;//%/.% ✓//„i .l'////' //i
/;l
'S "EM CONS?` / //, /i „%
RUC ION,LI N LAVH INFORMATION
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
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 County 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, 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
commencing work or recording our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Co tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST.LUCIE COUNTY OF ST.LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 1JOV.e v,n ,� ., 20 [Xby thisaa day of20 L by
CHRISTOPHER W.RICHMOND CHRISTOPHER W.RICHMOND
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Flor' ) (Signature of Notary Public-State of Florid
Personally Known x OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF 90 aI Commission No. FF 909099
o ey Notary PublicState of Florida owR'°�eG Notary Public State of Florida
Deana M Dailey Dea
linal, Dailey
Iy n My Commission FF 909099
9'r`or r�o� Expires 08/12/2019 �'ta P`o�� Expires 08/12/2019
Revised 07/15/201
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMP LETE
INITIALS