HomeMy WebLinkAboutApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/20/2021 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 X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
TBD
Legal Description: PLAT OF AVALON PARK S 207 FT OF E 432 FT OF W 664.34 FT OF SEC II (2.05 AC) (OR 795-2406)
Property Tax ID #:
Site Plan Name: _
Project Name: ___
Setbacks Front
1410-501-0017-010-5
ST, LUCIE COUNTY UTILITIES
BRYN MAWR PROJECT
Back: Right Side: Left Side:
Lot No._
Block No.
DETAILED DESCRIPTION OF WORK: I
INSTALL NEW METER CAN, RISER, 200A PANEL. SINGLE PHASE SERVICE, SIX LIGHTS,
INTERIOR OUTLETS, TWO EXTERIOR OUTLETS AND TWO CONNECTIONS FOR MINI SPLIT
AIR UNITS BY OTHERS
Additional work to brtormed under this permit— check all apply:
E]HVAC LJ Gas Tank Gas Piping _ Shutters E]Windows/Doors
21 Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2,500.00 Utilities: 0 Sewer E Septic Building Height:
OWNER/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@RICHMONDE:LECTRICINC.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 Owne / Lessee/Agent Signature of Cont actor/License Holder
STATE OF FLORIDA
COUNTY OF ST.LUCIE
Theoing instr ment.was acknowledged before me
this orgday of 20 21 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 No. GG326515
Revised 07/15/2014
App 04 � _ Notary Public State of
% `f� Deana M Dailey
Expires 0A IW023
STATE OF FLORIDA
COUNTT fVOF ST.LUCfE
The forgoing instrument was acknowledged before me
this Z.o day of,�f tl , 202 L by
CHRISTOPHER W. RlCHMOND
(Name of person acknowledging)
(Signature of Notary Public- State of Florida
Personally Known x OR Produced Identification
Type of Identification Produced
On NO. GG 326515 ey�]�taTy Public State of
Deana M Dailey
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