HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/24/2022 Permit Number:
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 8001 IMMOKOLEE ROAD
X
Legal Description: 35 34 39 W 231 FT OF E 447 FT OF S 356 FT OF N 381 FT OF W 1/2 OF NW 114 OF NE 1/4
(MAP 13/35N) (1.89AC)
Property Tax ID ifs 1335-122 0002-000-1
Site Plan Name:
Project Name:
Setbacks Front Back:
NORTHSIDE WORSHIP CENTER, INC.
Right Side
Left Side:
Lot No. —
Block No.
DETAILED DESCRIPTION OF WORK: I
TEMPORARY POWER POLE.
CONSTRUCTION INFORMATION:
Additional work to be Dertormed under tis permit -
c ec a apply:
11HVAC Gas Tank [:]Gas Piping _ Shutters O Windows/Doors
Electric ❑ Plumbing Sprinklers Generator ❑ Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction, $ 400.00 Utilities:cn Sewer OSeptic
Building Height:
OW N E RAESSEE:
CONTRACTOR:
Name NORTHSIDE WORSHIP CENTER, INC_
Name:
Christopher W. Richmond
Address: 3100 ST_ LUCIE BLVD
City: FORT PIERCE State: FL
Zip Code: 34946 Fax:
Phone No.
Company:
Richmond Electric, Inc.
Address:
3086 Enterprise Road
City.
Zip Code:
Phone No.
Fort Pierce State: FL
34982 Fax: 772-461-1907
772461-1951
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 MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER
Name:
Address:
City:
Zip: Phone: _
Not Applicable I BONDING COMPANY:
Name: _
Address:
City:
Zip: Phone:
l certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
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 fallowing 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
commenciniz work or recording vour Notice of Commencement.
/-_f• —_
s
_ Signature of Owner/ Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF St. LuOe
The forgoing instrument was acknowledged before me
this Zqday of /wIn.-6 � 20 1Lby
Christopher W. Richmond
(Name of person acknowledging)
re of Notary Public- State of Florida )
Personally Known X OR Produced Identification
Type of Identification Produced
Commission No. HH
Revised 07/15/2014
Notary Public State of Flcrids
Deana Mirabella
Exp.
STATE OF FLORIDA
COUNTY OF St. Lucie
The forgoing instrument was acknowledged before me
this .21 a, day of 022, 4-66 .20 Z_ by
Chrstopher W. Richmond
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
No. HH 2O3876
No aryVpile State of Florida
Deana Mirabella
My Commission
Exp. 8112/2023
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