HomeMy WebLinkAbout BUILDING PERMIT APPLICATION & PICTURES OF METERALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 214i2022 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:
Legal Description:
10410 Bluefield Road
1 37 37 All of Sec 1 (656.11 AC) (or 2920-1228)
Property Tax ID #: 4101-111-0002-000-7
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No._
Block No.
DETAILED DESCRIPTION OF WORK: I
Remove and replace 2" weather head. Like for Like. Secure riser.
Additional work to be ertormed under this permit— cnecK an Mappiy':HVAC
L Gas Tank ❑Gas Piping — Shutters a Windows/Doors
Electric E] Plumbing Sprinklers ❑ Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 800.00 Utilities:cn Sewer ❑ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name South Fla Water Mgmt Dist Attn: Land Management
Name. Christopher W. Richmond
Address: P.O. Box 24680
Company: Richmond Electric, Inc.
City: West Palm Beach State: FL
Zip Code: 33416 Fax:
Phone No.
Address: 3086 Enterprise Road
City: Fort Pierce State: FL
Zip Code: 34982 Fax: 772461-1907
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_
C SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION. I
DESIGNER/ENGINEER: _ Not Applicable
Name: _
Address:
City:
Zip:
Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: _
Address:
City:
Zip:
Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address.
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: _
Address:
City:_
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
St. Lucie County makes no representation that is granting a permit will authorize the germit 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.
s
Signature of Owner/ Lessee/Agent Signature of Contr ctor/License Holder
STATE OF FLORIDA
COUNTY OF St. Lucie
The forgoing instrument was acknowledged before me
this day of C000_4,!or , 20'Um by
Christopher W. Richmond
(Name of person acknowledging)
'r—
(Signature of Notary Public- State of Florida )
Personally Known X OR Produced Identification
Type of Identification Produced
Commission No. HH 2O3816 $e p[ary Public State of
'Deana Mirabella
��__,,______ My commission
r�l►1 HH 203876
Revised 07/ 15/2014
STATE OF FLORIDA
COUNTY OF
St. Lucie
The forgoing instrument was acknowledged before me
this '"f day o rU 20 22— by
Christopher W. Richmond
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known X OR Produced Identification
Type of Identification Produced! _
Hh 2.03876 I8 Public State of
n No. � a Mirabella
AM
C mflliiili M1 29 878ion
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