HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/19/2022 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:
4286 Christensen Road
Legal Description: 32 35 40 S 112 of S 330.45ft of N 826.16ft of W 112 of NW 114 of SE 114 - Less W 25ft for RD RMI
(2.40 AC) (OR 1656-34:1808-2940; 2284-2886: 2953-313)
Property Tax ID #: 2432-423-0001-040-1
Site Plan Name:
Project Name: Gabrieie Klaesen
Setbacks Front Back:
I DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Lot No. —
Block No.
Install a 100amp sub panel in the new shed. Eight interior receptacles, two exterior receptacles, two
lights and one fan.
idifflional work to be
E1HVAC
❑✓ Electric
ertormed
n
under this permit —cnecK all apply.
Gas Tank Gas Piping _ Shutters Q Windows/Doors
Plumbing 1:1Sprinklers El Generator 1:1 Roof
❑
Total Sq. Ft of Construction:
Cost of Construction: $ 5,490.00
S Ft. of First Floor -
Utilities: _
LSewer Septic
Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name Gabriele Klaesen
Name: Christopher W. Richmond
Address: 4286 Christensen Road
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: EC0001963
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requirea.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 your Notice of Commencement.
_ Signature of Owner/ Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF St. Lucie
The forgoing instrument was acknowledged before me
this 1 in day of 201�y
STATE OF FLORIDA
COUNTY OF
St_ Lucie
The forgoing instrument was acknowledged before me
this 1I day of 20 4_2 by
Christopher W. Richmond Christopher W. Richmond
(Name of person acknowledging) (Name of person acknowledging)
: _0_01A I — V",� a��A .
(Signature of Notary Public- State of Florida ) (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
Commission No. HH2o3876 mission No. HH2o3876 (Seal)
Notary Public State of Florida
Deana Mirabella Notary Public State of Florida
Revised 07/15/2014
Exp.
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