HomeMy WebLinkAboutBuilding permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
2/11/2021 Permit Number:
Date.
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 3711 PROMENADE WAY
Legal Description: ESTATES OF LONGWOOD LOT 43 (0.42 AC)
Property Tax ID #: 2433-502-0043-000-0
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
REPLACE FIRE DAMAGED HOUSE PANEL. LIKE FOR LIKE.
X
Lot No. 43
Block No.
A �tiona war to be ertormed under tnus permit— cnecx an aupty:
❑HVAC 0 Gas Tank Gas Piping _ Shutters ❑ Windows/Doors
21 Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 1,200.00 Utilities:'n Sewer 1-1 Septic Building Height: _
OWNER/LESSEE:
CONTRACTOR:
Name JEFFREY J JENSEN
Name: THOMAS E. RICHMOND
Address: 3711 PROMENADE WAY
Company: RICHMOND ELECTRIC, INC
City: FORT PIERCE State: FL
Zip Code: 34982 Fax:
Phone No.
Address: 3086 ENTERPRISE ROAD
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772461-1907
Phone No. 772-461-1951
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: DEANA@RICHMONDELECTRICINC.COM
State or County License: ECO001458
If Value of construction is 52500 or more, a KtLLJKUtU niour-e Oi l.OmmenceMa11• M rcyutIcu.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
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.
Signature of Owner/ Lessee/Agent nature of Contractor/Li ense Holder
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The forgoing instrument was acknowledged before me
this L day of Jeb2-0 ; by
THOMAS E. RICHMON❑
(Name of person acknowledging)
STATE OF FLORIDA
COUNTY OF -AUCIE
The forgoing instrument was acknowledged before me
this N day of — e L44 j_L1__, 20 tL_ by
THOMAs E. RICHMOND
(Name of person acknowledging)
K-, a
[Signature of Notary Public- State of Florida } (Signature of Notary Public- State of Florida
Personally Known x OR Produced identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. GG326515
Revised 07/15/2014
�Nothlic state of Florida �ommission No. GG 326515
Deana M Dailey
i My C"rrissian GG 326515
State cf Florida
Deana M
Expires Call212023
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DATE
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INITIALS