HomeMy WebLinkAboutBUILDING PERMIT APPLICATION & DRAWINGALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/29/2021 Permit Number:
a _
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 x Residential
Phone: (772) 462-1553 Fax: (772) A62-1578 Commercial
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
BLUEFIELD ROAD
Address:
2/31419/10111/12113/14115/23124125126136137 37 (AKA BLUEFIELD GROVE) THAT PART OF SECTIONS
Legal Description:
AND THAT PART OF SEC 9 LYG E OF BLUEFIELD RD AND THAT PART OF SEC 10
MPDAF: ALL OF SECTION 2 AND 3 AND THAT PART OF SEC 4 LYG E OF BLUEFIELD RD
Prope rtyTax ID #: 4101-111-0002-010-0
Site Plan Name: WATER PUMP
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CLEAN UP EXISTING METER/MAIN ON POLE.
DRIVE SECOND ROD AND CONNECT TO EXISTING GEC
CLEAN UP PUMP SHED PANEL, CONDUITS, WIRING IN WATER PUMP SHED.
HOT CHECK ONCE ENERGIZED.
Lot No.
Block No.
CONSTRUCTION INFORMATION:
A I[lona war to e e orme un er this perm+t — c ec a app y:
❑HVAC Gas Tank F]Gas Piping _Shutters a Windows/Doors
✓Z Electric ❑ Plumbing O Sprinklers []Generator 0 Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 1,000.00
OWNER/LESSEE:
S Ft. of First Floor:
Utilities. Sewer 1:1 Septic
Name EVANS PROPERTIES, INC
Address: 660 BEACHL.AND BLVD, SUITE 301
City: VERO BEACH State: FL
Zip Code: 32963 Fax:
Phone No.
F_nna;l-
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Building Height:
Name: Christopher W_ Richmond
Company: Richmond Electric, Inc.
Address: 3086 Enterprise Road
rirv: Fort Pierce
_ State: FL
Zip Code:
34982 Fax: 772461-1907
Phone No. 772-461-1951
E-Mail: deana@richmondelectricinc.com
State or County License: ECO001963
if value of canstruction is $z50U or more, a RECDRDi D Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: — Not Applicable MORTGAGE COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
State
Not Applicable
Name: _
Address:
City:
Zip:
Phone:
State:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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
structure. ture. Please consult with pyour applicable
lome Owners owners
Association t nd review your aws deed for any estrict that
which may restrict apply obit such
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 recordi vour Notice of Commencement. r
Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF
St. Lucie
Signature of C" ontractor icense Holder �s
STATE OF FLORIDA
COUNTY OF SL Lucie
The forgoing ins ument was acknowledged before me The forgoing instr ment was acknowledged before me
thi day of &M 20 Eby thisz� day of C- 2D by
CHRISTOPHER W. RICHMOND CHRISTOPHER W. RICHMOND
(Name of person acknowledging) (Name of person acknowledging)
"� nature of Nota Public- Stat�WfFlori
(Signature of Notary - Public- State of Florida) ( Si g ry
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced Type of identification Produced
HH 2o3fi76 Hai Public State of Flp I?- mission No. HH 20387 Nota A� la Stet. of Florida
Commission No.
Deana Mirabella Deana Mirabella
mycommission ivly Commissiaa
Xp. 8/12/2023 EXp, 8/1212023
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
a o