HomeMy WebLinkAboutApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/5/2021 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fora- 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
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: 2103 37 41 that part of S 464.92ft of N 1785.84ft of fract secslyg btw Ind River and A1A and S LI of S 464.92
ft of N 1785.84ft, TH N 1 Deg 39 min 31 Sec W 160ft, TH N 12 Deg 36 Min 07 Sec W 310.4ft, TH E 375ft Tow RIW A1A
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front
4502-231-0001-000-0
St. Lucie County Mosquito Control
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter can. Like for Like.
Lot No._
Block No.
Additional work to bnGasTank
rtormed under this permit — check all apply:
11HVAC Gas Piping _ Shutters ❑ Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 600.00 Utilities:] Sewer OSeptic Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name St. Lucie County
Name: CHRISTOPHER W. RICHMOND
Address: 2300 Virginia Avenue
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: 772-461-1907
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: ECO001963
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:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
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 your Notice of Commencement.
_ Signature of wner/ Lessee/Agent Signature of Contra tar/License Holder
STATE OF FLORIDA
COUNTY OF ST.LME
The for oing instru ent was acknowledged before me
this,! day of 20Z1 by
CHRISTOPHER W. RICHMON❑
(Name of person acknowledging)
of Notary Public- State of Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/ 15/2014
STATE OF FLORIDA
COUNTY OF ST LUCIE
The forgoing instrument was acknowledged before me
this day of / 20 Z by
CHRISTOPHER W. RICHMOND
(Name of person acknowledging)
4o
ignature of Notary Public- State of Florid
Personally Known x OR Produced Identification
Type of Identification Produced
Notary yyState of Rorida Commission N
DeanM liiey
My Commission GG 32E
fV N 446`ta1 / Public State of Florida
Deana M Dailey
My Commission GG 325515
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