HomeMy WebLinkAboutBuilding permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/17/2020 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
PROPOSED IMPROVEMENT LOCATION:
Address: 5514 PALMETTO DRIVE
Legal Description: INDIAN RIVER ESTATES - UNIT 06 - BLK 22 LOT 16 AND N 1/2 LOT 17
(MAP 34/11 N) (OR 3176-1585)
Property Tax ID #: 3402-607-0241-000-7 Lot No. 16 8 N 1/2 LOT 17
Site Plan Name: SAM WOLKOWSKY Block No. 22
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALL (2) 20A, 120V BRANCH CIRCUITS TO NEW SHED. FEED FROM EXISTING EXTERIOR
SUB -PANEL. USE TANDEM BREAKERS TO MAKE SPACE FOR NEW CIRCUITS. INSTALL 1/2" PVC
IN TRENCH FROM SUB -PANEL TO 1/2" PVC STUB - DOWN FROM SHED. INSTALL COPPER
BRANCH CIRCUIT CONDUCTORS AND TERMINATE TO EXISTING SHED WIRING.
CONSTRUCTION INFORMATION:
Additiona wor to je�e orme un er t is permit — cneck all thalapp y:
aHVAC
u Gas Tank Gas Piping_ Shutters a Windows/Doors
Electric ❑ Plumbing Sprinklers ❑
Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2,216.00 Utilities: �_ Sewer ❑ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name SAM WOLKOWSKY
Name: CHRISTOPHER W. RICHMOND
Address: 5514 PALMETTO DRIVE
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: 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: _
Address:
City:
Zip:
Phone:
FEE SIMPLE TITLE HOLDER
Name:
Address:
City:
Zip: Phone:
State
Not Applicable
MORTGAGE COMPANY
Name: _
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
State:
Not Applicable
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 your Notice of Commencement.
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The forgoing instrument was acknowledged before me
thist'l day of Q� - 202Dby
CHRISTOPHER W RICHMOND
(Name of person acknowledging )
Signature of Notary Public- State of Florida
Personally Known x OR Produced Identification
Type of Identification Produced
Commission N
Revised 07/ 15/2014
Notary Public State of Florid
ne2YFia_A-Bafley
+ar My Commission GG 326515
wa Expires08r12/2023
I
s
Signature of Contra cto�cense Holder
STATE OF FLORIDA
COUNTY OF s- LICIE
The forgoing instrument was acknowledged before me
this L-L day of f} 20�Z by
CHRISTOPHER W. RICHMOND
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
Commission N
Notary Public State of Florida
Deana M Dailev
Expires 0811212023
---VW
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
SAM WOLKOWSKY
5514 PALMETTO DRIVE
PROPOSAL
ATTENTION: jdg777X2@aol.COII1
RICHMOND ELECTRIC
3086 ENTERPRISE ROAD
FT. PIERCE, FLORIDA 34982
772461-1951
FAX 772461-1907
PHONE: DATE:
(772) 577-1234 8/11/20
JOB NAME AND LOCATION:
ELECTRIC TO NEW SHED
PROPOSE TO WIRE AS FOLLOWS:
INSTALL (2) 20A,120v BRANCH CIRCUITS TO NEW SHED.
FEED FROM EXISTING EXTERIOR SUB -PANEL. USE TANDEM BREAKERS TO MAKE SPACE FOR NEW CIRCUITS.
INSTALL 1/2" PVC IN TRENCH FROM SUB -PANEL TO lh" PVC STUB -DOWN FROM SHED. INSTALL COPPER
BRANCH CIRCUIT CONDUCTORS AND TERMINATE TO EXISTING SHED WIRING.
CHECK EXISTING, OBSERVABLE WIRING IN SHED AND INSTALL DEVICES. NEW DEVICES INCLUDE (2) GFI
RECEPTACLES, (4) STANDARD DUPLEX RECEPTACLES, (1) SINGLE -RECEPTACLE, AND (2) WHITE SLIDE -BAR,
SINGLE -POLE DIMMER SWITCHES.
PULL ST. LUCIE COUNTY ELECTRICAL PERMIT.
WE PROPOSE HEREBY TO FURNISH MATERIAL AND LABOR - COMPLETE AND IN ACCORDANCE WITH ABOVE
SPECIFICATIONS FOR THE SUM OF:
TWO -THOUSAND, TWO -HUNDRED SIXTEEN DOLLARS & 00/'I00s------ —--- ------- ------------ $ 2 216 00
PAYMENT TO BE MADE AS FOLLOWS:
1,100.00 UPON ACCEPTANCE $1 1_16.00 UPON COMPLETION
ANY ALTERATION OR DEVIATION FROM ABOVE SPECIFICATIONS INVOLVING EXTRA COSTS WILL BE EXECUTED ONLY UPON
WRITTEN ORDER AND WILL BECOME AN EXTRA CHARGE OVER AND ABOVE THE ESTIMATE. ALL AGREEMENTS CONTINGENT
UPON STRIKES, ACCIDENTS OR DELAYS BEYOND OUR CONTROL. THIS PROPOSAL MAY BE WITHDRAWN BY US IF NOT ACCEPTED
WITHIN THIRTY (301 DAYS.
ACCEPTANCE OF PROPOSAL - THE ABOVE PRICES, SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY AND ARE HEREBY
ACCEPTED.
YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED.
DATE OF ACCEPTANCE: V 12-` 2, �v
SIGNATUREc . A�v_