HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED C
Date: d Permit Number:
RECEIVED APR.2 0 2015
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: Electrical
PROP05ED'iIUiPR01/EMENT
Address: 4202 Matanzas Ave., Fort Pierce, FL
Legal Description: HARMONY HEIGHTS NO 4 BLK 19 LOT 4
Property Tax ID#: 1431-801-0218-000-7 Lot No.4
Site Plan Name: Block No. 19
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETA)LED DESCRIPTION„'O$F OR ,
REPLACE EXISTING 2” RISER AND WEATHERHEAD AT METER LOCATION.
REPLACE METER CAN IF NECESSARY.
C_ONSTRUCTIQN INFORMATION
Additional work toe e orme un er t is permit–check a appy:
HVAC Ei Gas Tank []Gas Piping _Shutters Q Windows/Doors
❑✓—Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ -7 S C1 J Utilities:0Sewer[]Septic Building Height:
01NNER/LESSE.`NORTHSICEV1/ORSHIPICENTER3' C£lNTRACTOR 'RiC1lUlrONI7ELECTRiC INC
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Name Northside Worship Center Name: Christopher W.Richmond
Address:3100 St. Lucie Blvd. Company: Richmond Electric Inc.
City: Fort Pierce State:FL Address: 3086 Enterprise Rd.
Zip Code: 34946 Fax: City: Fort Pierce State:FL
Phone No.772-321-9115 Zip Code: 34982 Fax: 772-461-1907
E-Mail: Phone No. 772-461-1951
Fill in fee simple Title Holder on next page(if different E-Mail: casey@richmondelectricinc.com
from the Owner listed above) State or County License: EC00019631 17642
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Sl1PPLEMENTAL'CONSTRUCTION LIEN I.AVV INEORM%�TION
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: 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 our Notice of Commencement.
e
Ls' s
_Signature of Owner/Lesse Agent Signature of Contra'Etor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St.Lucie COUNTY OF St.L.de
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 16' day of 20 Fs by this hday of 20 sW by
Christopher W.Ri&mond Christopher W.Richmond
(Name of person acknowledging) (Name of person acknowledging)
(Signature ofOobtary Public-State of Florida) (Signature Public-State of Florida)
Personally Known y OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.EEW 954 (Seal) I Commission No. 6E 1 r78-9eat-
•i►Av?�' CASEY BINDLE
AV, CASEY BINKLEV =IhAMSION
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•'cMY COMMISSION#EE117856 '
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,�• ,--;,i� EXPIRES August 16,201
Revised 07/15/2014 .;T ,.�
EXPIRES August 1s,2015
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