HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �y
Date: MARCH 24, 2017 8G BYED Permit Number:
M. '_ St. WcieCounty RECElVED
Building Permit Application MAR 2 4 2017
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: 9545 RANGE LINE ROAD
Legal Description: 0137 38 BEG AT NE COR OF SEC RUN S 00 00 54 SEC W ALG E SEC LI 1400.17 FT, TH N 89 59 06 SEC W 464.67 FT
TH N 44 46 00 SEC E 330.01 FT, TH N 00 00 54 SEC E 937.46 F TO SLY RIW FEC RR, TH N 44 46 00 SEC E ALG SD RAN 321.47 FT MIL TO N SEC LI
Property Tax ID #: 4201-111-0001-010-0
Site Plan Name:
Project Name: ALLIED UNIVERSAL CORPORATION
Setbacks Front Back: Right Side
I DETAILED DESCRIPTION QF WQRK:
INSTALL 30 FT POLE WITH TWO LED LIGHTS
Left Side:
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Aaanional worK to DfIrrormed
under
tispermit—check
all
apply:y
❑
❑HVAC
Gas Tank
❑Gas Piping
_ Shutters
❑
Windows/Doors
❑✓— Electric ❑ Plumbing
[]Sprinklers
❑ Generator
❑
Roof
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $ 2000.00
Utilities:�Sewer
❑Septic
Building Height:
'OWNER/LESSEE: ;
CONTRACTOR:
Name CHEM-TEX SUPPLY CORP.
Name: CHRISTOPHER W. RICHMOND
Address: 3901 NW 115 AVENUE
Company: RICHMOND ELECTRIC, INC
City: MIAMI State: FL
Zip Code: 33178 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 required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.y p
DESIGNER/ENGINEER: _
Name: Tenors /il- %a Rick
Not Applicable
MORTGAGE COMPANY: —Not Applicable
Name:
Address: 3828 Vwr
Address:
City:_Alss),r+ ee " b
Zip: 7 Y74G phone: _ yp-t -35
State: FL
0 S 373
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
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
_ Signature o Owner/ Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF STAUCIE
The for Ding instrument was acknowledged before me
this day of rwCLji'CJr% . 20(---:F by
CHRISTOPHER W. RICHMOND
(Name of person acknowledging )
(Signature of Notary
Personally Known x
Type of Identification
Commission No. FF
Revised 07/15/2014
Deana,M pailey
My C ilk on FF 909099
Expires 08/12/2019
STATE OF FLORIDA
COUNTY OF_� LUCIE
The forgoing instrument was acknowledged before me
thisZL{ dayofVYlCXC.K .20i_'J_ by
CHRISTOPHER W. RICHMOND
j(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known x OR Produced Identification
Type of Identific!�FF
Pr ced
09 �Notary Public State o1 Florida
Commission No.+� 1 Deana(kg)ley
y, My Commission FF 909099
"111 Expires 0811212019
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