HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/29/2021 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 Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 8001 IMMOKOLEE ROAD
Legal Description: 35 34 39 W 231 FT OF E 447 FT OFS 356 FT OF N 381 FT OF W 1/2 OFNW 1/4 OF NE 1/4
(MAP 13135N)(1.89AC)
Property Tax ID#: 1335-122-0002-000-1 Lot No.
Site Plan Name: Block No.
Project Name: NORTHSIDE WORSHIP CENTER, INC-
Set backs Front Back: Right Side: Left Side.
DETAILED DESCRIPTION OF WORK:
REPLACE 200AMP PANEL LIKE FOR LIKE. REMOVE 2 FUSE PANELS AND REFEED THE
EXISTING CIRCUITS. CORRECT AIR UNITS WIRING. INSTALL CONDUIT AND WIRING TO SHED
AND PUMP. INSTALL GFI RECEPTACLES WHERE NEEDED. REFEED WATER HEATER.
CONSTRUCTION INFORMATION:
Additional work to be performed under t is permit--check all apply:
1:1HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
❑✓—Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 13,925.00 Utilities:Sewer 0 Septic Building Height:
OWNER/LESSEE CONTRACTOR:
Name NORTHSIDE WORSHIP CENTER, INC_ Name: CHRISTOPHER W. RICHMOND
Address: 3100 ST. LUCIE BLVD Company: RICHMOND ELECTRIC, INC
City: FORT PIERCE State: FL Address: 3086 ENTERPRISE ROAD
Zip Code: 34946 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 MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: 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 Signature of Contra or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST.LUCTE COUNTY OF ST.LUCE
The for ping instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day ofY34orl ! 20ZLby this p�day of 4prj 1 20 24--by
CHRISTOPHER W.RICHMOND CHRISTOPHER W.RICHMOND
(Name of person acknowledging) (Name of person acknowledging)
J �
(Signature of Notary Public-State of Flor' f (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
GG 326515 mission NO. GG 326 115
COmm[SSIOn No. GG
N iary ublic Stale of Florida
�,►*� Notary Public State of Ftoride +' Deana M Dailey
Deana M Dailey
' pp f xpires mismon _10.&dF Expires Dsf1212023
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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