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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 9/21/2021 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: Pnal D4­,rrintinn- 2308 GRAND OAK ESTATES POA SOUTHERN OAK ESTATES ALL STREETS - LESS AUTUMN COURT - Property Tax ID #: 3404-710-0001-000-6 Site Plan Name: Project Name: Setbacks Front Back I DETAILED DESCRIPTION OF WORK: 189 AC) (AS PER PLAT DEDICATION) Right Side: Left Side: Lot No._ Block No. DISCONNECT & SAFE: OFF EXISTING ELECTRIC SERVICE AND PANEL ON GUARD HOUSE AT ENTRY. REBUILD SERVICE ON RIGID RACK IN SAME LOCATION AS EXISTING SERVICE (10, 100A, 120/240v). REHOOK EXISTING PUMP TIMECLOCK, LIGHTING TRANSFORMER, PHOTO -CELLS, PUMP START RELAY, AND IRRIGATION CONTROLLER ON NEW RACK. INSTALL WP GFI PROTECTED RECEPTACLE ON RACK. iditional work to be ertormed 0HVAC Tank unclerthis permit —cnecK ail Gas Piping tnat apply: Shutters ❑ Windows/Doors Gas _ Electric ❑ Plumbing Sprinklers E] Generator Roof Total Sq. Ft of Construction: Cost of Construction: $ 2,500,00 S Ft. of First Floor: Utilities:Sewer Septic Building Height: OWNERAESSEE: CONTRACTOR: Name SOUTHERN OAK ESTATES POA Name: CHRISTOPHER W. RICHMOND Address: 2308 GRAND OAK AVENUE Company: RICHMOND ELECTRIC, INC City: FORT PIERCE State: FL Zip Code: 34981 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@RICHMONDELECTRICINC.COM State or County License: ECO001963 if value of construction is $2500 or more, a RECORDED Notice of Commencement is required. 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. OWNER'S ELECTRONIC SUBMISSION STATEMENT: Under penalty of perjury, I declare that all the information contained in this building permit application is true and correct. Must be sizued by ownexlagen (Signature of contractor) (Signature of Owner or Agent (including contractor)) ��•J� State of Florida, County of St. Lucie Affirmed to and subscribed before me this O 2 20 21 , by Christopher W. Richmond personally known to me or who has produced as identificatiom-- State of Florida, County of St. Lucie Affirmed to and subscribed before me thi 20 21 , by Christopher W. Richmond personally known to me or who has produced as identification. Notary 5ignatur ' !L • Notary Signature ♦�—• •--� Notary Public Stat of Florida Notary Public State aR Florida Deana M Dailey , Deana M Dailey Notary (print name) miagion �� 328515 tary (print name) Deana M My Cbm:Etiesiran GAG 32fi6t5 a a Construction documents must accompany this application. The Florida energy code submitted becomes an Integra t pass final inspection. "Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public record of this county, and there may be additional permits required from other governmental entities such as waste management district, state agencies, or federal agencies. "SIGNATURE OF TIE APPLICANT MUST BE NOTARIZED_ If owner builder, applicant must sign in person_ BUILDING: PERMIT includes: Building, Electrical, Plumbing, Mechanical, and Sewer only_ All other trades require separate applications. Asbestos compliance: It is the owner's or operator's responsibility to comply with section 469.003, Florida Statutes, and to notify the Deaartment of Environmental Protection of his or her intentions to remove asbestos, when applicable, in accordance with state and federal law. FEE SIMPLE TITLEHOLDER, BONDING COMPANY AND MORTGAGE LENDER INFORMATION IS REQUIRED WHEN THE AGGREGATE VALUE (TOTAL COST OF ALL IMPROVEMENTS AND NOT JUST WORK AUTHORIZED BY THE INDIVIDUAL PERMIT) IS $2500 OR MORE (EXCEPT HVAC REPAIR/REPLACEMENT< $7500). PLEASE ADDRESS ALL ITEMS. Fee Simple Titleholder's Name (if other than owner): Address: City: Mortgage Lender's Name: Address: City: ❑ Same as Owner State: Zip: 0 Not Applicable State: Zip: Bonding Company © Not Applicable Name; Address: City: State: Zip: OFFICE USE ONLY Is the property located in a Special Flood Hazard Area (floodplain) per the current Flood Insurance Rate Map (FIRM) ❑ Yes ❑ No Flood Zone: Reviewed by: Determination: Permit Fee $ Other State Surcharge Subcontractor Other Plan Review Fee Routing Fee Flood Review Fee $ Other Total Amount Due at Issuance $ Remarks Reviewed by Date Final Check Active Code Violation ❑ Yes ❑ No Case # Case Type Date Page 2 of 2