HomeMy WebLinkAboutCCFALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6-3-2019 Permit Number:
10-0
-Now� Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMITAPPLICATION FOR: To Select from dropbox click arrow at the end of line
PROPQSED IMPROVEMENT LOCATION:
Address: 524 BANANA LANE
Legal Description: PALM GROVE S/D BLK J LOT 34 (0.12 AC) (OR 1525-1768: 1543-2991)
Property Tax ID #: 3410-503-0286-000-0
34
Lot No.
Site Plan Name: Block No. J
Project Name:
Setbacks Front Back: Right Side: Lek Side:
DETAILED DESCRIPTION OF WORK:
INSTALL UPGRADED WIRING FOR NEW AIR HANDLER UNIT.
CONSTRUCTION INFORMATION:
itiona wor to e e orme un ert is permit—c ec a app y:
jj�� I c
jjL� IIHVAC Gas Tank ❑Gas Piping II��_I Shutters Windows/Doors
LY Electric 0 Plumbing Sprinklers U Generator Roof
Total Sq. Ft of Construction: Sct. of First Floor:
Cost of Construction:$ 600.00 Utilities:n Sewer DSeptic Building Height:
OWNER/LESSEE:
ONTRACTOR:
Name DOROTHY R KLIMMEK
Name: CHRISTOPHER W. RICHMOND
Address: 524 BANANA LANE
Company: RICHMOND ELECTRIC, INC
City: FORT PIERCE State: FL
Address: 3086 ENTERPRISE ROAD
Zip Code: 34982 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: DE ANA�RICHMONDELECTRICINC.COM
from the Owner listed above)
State or County License: EC0001963
If value of construction is $2500 ar more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: II
Name: --
MORTGAGE COMPANY: _Not Applicable
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.
which is in conflict with any applicable Home OwnerscAsmcPtion rules abylaws or antl covenants that build
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
commencine work or rernMincr vnnr funti—.,c
6e-e v tVA-k.�
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF .T. was
The f r Ding instrr4yjIIp�ent was acknowledged before me
this day of %HOG 20If by
CHRISTOPHER W. RICHMOND
)Name of person acknowledging )
t�10�-_ )
(Signature of Notary Public -State of Floj a)
Personally Known x OR Produced Identification
Type of Identification Produced
�v 5
Signature of Contra or/License Hotler
STATE OF FLORIDA
COUNTY OF aT. was
The for Ding instrument was acknowledged before me
this day of;uAC 20 IL by
CHRISTOPHER W RICHMOND
(Name of person acknowledging I
(Sig . .(0�aOR M .6)� lo Lci
nature of Notary Public- State of Florida)
Personally Known
Type of Identifical
Commission No. FF NmaryfSeWlswear Faaim Commission No.
Deana M C iey
N My Commission FF 909099
OR Produced Identification
N tery Pubis,Sta* of FMMa
M Dailey
My commission FF 900"s,
EtiplreF0811212019
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MANGROVE
REVIEW
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INITIALS