HomeMy WebLinkAboutScanALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. 4/20/2021
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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: 5401 Deleon Avenue
Legal Description: Lakewood Park Unit 12 - BLK 165 Lot 15 (MAP 13112S) (OR 253-976. 1061-2152)
Property Tax ID #: 1301-614-0203-000-5 15
Lot No.
Site Plan Name: Block No. 165
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Riser is leaning over due to FPL wire being to tight
Re -secure riser correctly.
CONSTRUCTION INFORMATION:
Adairional work t0 e e orme under this permit— c N a app y:
11HVAC f Gas Tank ❑Gas Piping Shutters Q Windows Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction.
Cost of Construction: $
OWNER/LESSEE:
795.00
Sq. Ft. of First Floor:
Utilities:Sewer ❑—Septic Building Height:
Name Robert M & Kathleen Fowler
Address: 5401 Deleon Avenue
City: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: Christopher W. Richmond
Company:
Richmond Electric, Inc.
Address:
3086 Enterprise Road
City:
Zip Code:
Phone No.
Fort Pierce State: FL
34982 Fax: 772-461-1907
772-461-1951
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: _
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
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 our Notice of Commencement.
W
_ Signature of Own r/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The forgoing instrument was acknowledged before me
this2_0 day of A1pcxJ 20Zd_by
CHRISTOPHER W. RICHMOND
(Name of person acknowledging)
s
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF ST.LUCIE
The forgoing instrument was acknowledged before me
this z a day of 4 pC % 20 Z 1 by
CHRISTOPHER W_ RICHMOND
(Name of person acknowledging)
(Signature of Notary Public- State of Florida) U (Signature of Notary Public- State of Florida )
Personally Known X OR Produced Identification
Type of Identification Produced
commission No. GG326515
Revised 07/ 1 S/2014
REVIEWS FRONT
COUNTER
DATE
COMPLETE
INITIALS
Personally Known X OR Produced identification
Type of Identification Produced
mission No. GG326515
Nwery Public State of F7or'
Deana M Daley
ea'nrniaaiprt GB-3g6
aM n Emr" W1212023
ZONING SUPERVISOR PLANS VEGETATION
REVIEW REVIEW REVIEW REVIEW
-')'*Wry Public ley of Flt7riai
Deana M Dailey
!� My Commission GG 326515
SEA TURTLE I MANGROVE
REVIEW REVIEW