HomeMy WebLinkAboutBUILDING PERMIT APPLICATION ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/16/2021 Permit Number:
- „ r
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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: 5410 ORANGE AVENUE
Legal Description: 7 35 40 E 3/4 OF E 1/2 OF SW 1/4 OF NW 1/4- LESS E 20 FT AND LESS TRACT IN SE COR
TO AMSLER AND LESS RD RIW-(79)(13.44 AC) (OR 1789-2994 THRU 2998: 2452-2835)
Property Tax ID#: 2407-231-0001-000-2 Lot No.
Site Pian Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REPLACE EXISTING SERVICE ON SAME/NEW POLE. LIKE FOR LIKE.
CONSTRUCTION INFORMATION:
Additional work to be oerformed under t is permit—check all apply:
❑HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 900.00 Utilities: Sewer❑Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name CYPRESS KNEE, LLC Name: CHRISTOPHER W. RICHMOND
Address: 5500 ORANGE AVENUE Company: RICHMOND ELECTRIC, INC
City: FORT PIERCE State: FL Address: 3086 ENTERPRISE ROAD
Zip Code: 34947 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: 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 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:
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[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 Ow er/Lessee/Agent Signature of Contrac r/License Horder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST.LUCIE COUNTY OF ST LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisLip day of III 20 Zfby this Jta_day of — 20;4_by
CHRISTOPHER W,RICHMOND CHRISTOPHER W.RICHMOND
(Name of person acknowledging) (Name of person acknowledging)
�ignatu_re of Notary Public-State of Flori ) (Signature of Notary Public-State of Florid )
Personally Known X OR Produced Identification Personally Known x OR Produced identification
Type of Identification Produced Type of Identification Produced
Commission No. GG326515 mmission No. GG 3265
.►� Notary Pubrio State of Florids Notary Public State of Florida
Deana M Dailey Deana M Dailey
« Expires 08/1212023 Expires 0 811 2/2 0 2 3
Revised 07/15/2014
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DATE
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2020-17-09 Click here for Legal Disclaimer
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