HomeMy WebLinkAboutapplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
7/22/2021 Permit Number:
CC)LINTY
F
L O
R 1 0 ^-
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
Residential
M
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 5151 N. Highway AlA# 612
Legal Description: Ocean Harbour Condominium A - Unit 612 and Undiv share in commonelements (or 1532-2664)
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front
1411-705-0026-000-7
Ocean Harbour Condominium A
Back: Right Side: Left Side:
Replace existing single phase, 125A load center panel in same location.
Lot No._
Block No_
Additional work to be perlormed under this permit — cnecK all apply:
❑HVAC 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: $ 1,043.00 Utilities:R Sewer 0 Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Narne Lazaro G. Alfonso
Name: Christopher W_ Richmond
Address: 7890 5W 73rd Place
Company: Richmond Electric, Inc.
City: Miami State: FL
Zip Code: 33143-4102 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: deanagrichmondelectricinc.com
State or County License: ECO001963
if value of construction is 52500 or more, a RECORDED Notice oT Commencement is requireo.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
State
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
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 tobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commenciniz work or recording your Notice of Commencement.
L�Ir' s
_ Signature of Owner/ Lessee/Agent Signature of Contra for/License Holder
STATE OF FLORIDA
COUNTY OF ST.LUCIE
The f r Ding instrument was acknowledged before me
this day of 20Eby
CHRISTOPHER W. RICHMOND
(Name of person acknowledging)
TSignature of Notary Public- State of Floridr)
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No.GrG- 3Z4e5l5
�-OT INI Notary P[fbIIG State of
Deana M Dailey
Expires res (?B1t2P2023
Revised 07/ 15/2014 or tv
STATE OF FLORIDA
COUNTY OF ST.LUCIE
The forgoing instrument was acknowledged before me
this 2,.'� day of 20l by
CHRISTOPHER W. RICHMOND
(Name of person acknowledging)
1
(Signature of Notary Public- State of Florida ]
Personally Known x OR Produced Identification
Type of Identification Produced
ej.O,NNotary Public State of Florida
Deana M Dailey^ ^^^�
Expiras 0811212023
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