HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date: 1 a0 Permit Number:
RECEIV-70 APR""p
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: Electrical
PROPQSED IN(PROVEMENT LOCATION
Address: 5500 ST LUCIE BLVD., FORT PIERCE, FL 34946 $ ECT 10I11
Legal Description: 30 34 40 SW 1/4 OF SW 1/4 LESS ASTRIP OF LAND ON E BEING 331.2 FT ON N LI AND 333 FT ON S LI
(OR 2947-659:3111-1969)
Property Tax ID#: 1430-331-0002-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED Df�SCRIPTIOU017"WORK ,
KE PLACE EXISTING &CA , I-).V--2 t0v RE DF,SrALS , COntDCA1r, < WLt?-IM67 j0 Io)S1Fes ,
RETP/-Acc E-Yii 'Vri(i IDU/ 120"2`IUv ;{.CJ��ftr f�rfr �1.
FCE 1p FrzpM EX ISIPNi�l Eta=l� CE N
PV G dv tT-,i A'�AWC, g b) ##8 Aw4 cA. w)LL .Va:&O ct y r �tSa�c c n�NS.
CONSTRUCT10N INFORMATION
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Additional work to be nertormed under this permit—cheCK all appy:
HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ 2 ,2 d d, Utilities.. _Sewer Septic Building Height:
OWNER�LESSEE ROAD RUNNER,TRAVEL RESORT LLC„ CONTRACTOR RICHMOND ELEM GNP,`
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Nam:ROAD RUNNER TRAVEL RESORT LLC Name: CHRISTOPHER W.RICHMOND
Address:5500 SAINT 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.772-464-0969 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: EC0001963/17642
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Sl1PPLEMENTAL CC?NST,RUCTION LIENrLAW INFORMATION
a „.,�
pp MORTGAGE COMPANY: Not Applicable
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DESIGNER ENGINEER: _Not Applicable cable
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
commencin&work or recording our Notice of Commencement.
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_Signature of Owner/Lessee/Agent Signature of Con•actor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST.LUCIE COUNTY OF ST.LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this .16'"day of 0pr'. t 20 IS by this a°71 day of Ar'. 1 20 L5' by
CHRISTOPHER V�.RICHMOND CHRISTOPHER W.RICHMOND
(Name of person acknowledging) (Name of person acknowledging)
y-to -is y -ao -is
(Signature otary Public-State of-Florida) (Signature f Notary Public-State Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission NO. EE117858 eal ommission No. EE117856 - (ST
- CASEY DINKLEY OA S' P3fiIt�3eLtCY
hAV rMAAARCZ,10DIt= =°C o= MY COMMISSION#EE1178
"T �d EXPIRES August 16,2015 '; of EXPIRES August 16,2015
Revised 07/15/2014 (4D7)398 Otb3 F!:ddallotarySerlice.com (407)398-0153 F:evidallotarySeraice.com
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS