HomeMy WebLinkAboutCCFALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2-26-2018 Permit Number:
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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
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
CEMENT LOCATION:
Address: 9255 GERMANY CANAL ROAD
Legal Description: 35 36 37 SE 1/4 OF SE 1/4 (42.55 AC) (OR 759-2557: 794-2610)
Property Tax IDN: 3135-441-0001-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side: _
HOT CHECK EXISTING ELECTRICAL SERVICE / PANEL TO BE REENERGIZED.
CONSTRUCTION INFORMATION:
CONTRACTOR:
Name JOHN 0. OLSON. JAMES R. OLSON, ANITA R. OLSON
Name: CHRISTOPHER W. RICHMOND
TF Itlona wor toe e
OGas
orme uncertIs permit — c ec
a
appy:
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-461-1907
Phone No. 772-461-1951
E -Mail:
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
Tank
❑Gas Piping
_Shutters
❑Windows/Doors
Il❑HVAC
��Il
L_JElectric ElPlumbing
Sprinklers
Generator
Roof
Total Sq. Ft of Construction:
SFt. of First Floor:
Cost of Construction: $ 1,200.00
Utilities:n
Sewer DSeptic
Building Height:
=OWNER/LESSEE:
CONTRACTOR:
Name JOHN 0. OLSON. JAMES R. OLSON, ANITA R. OLSON
Name: CHRISTOPHER W. RICHMOND
Address: 9321 DOLE CIRCLE
Company: RICHMOND ELECTRIC, INC
City: WINDERMERE State: FL
Zip Code: 34786 Fax:
Phone No.
Address: 3086 ENTERPRISE ROAD
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-461-1907
Phone No. 772-461-1951
E -Mail:
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
E -Mail: DEANA@RICHMONDELECTRICINC.COM
State or County License: EC0001963
11 .roue m mmuuawn rs paoou or more, a newnueu Notice or 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, 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
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_ Signature of Owner/ Lessee/Agent Signature of Cont actor/License Holder
STATE OF FLORIDA
COUNTY OF aT. woe
The forgoing instrument .w.a^s a.ckn'owledged before me
thisday of`20k2-by
STATE OF FLORIDA
COUNTY OF ST. was
The forgoing instrument was acknowledged before me
this 2-1, day ofFIiY� 20 a by
3R W RICHMOND CHRISTOPHER W. RICHMOND
person acknowledging I (Nameofperson acknowledging)
e of Notary Public. State of Hong ( (SI nature of Notary Public -State of Flor'
Personally Known x
Type of Identification
Commission
OR Produced Identification
NWary
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. FF
W FbMB
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS