HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED +�
Date: Permit Number: X04 - 5/
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
PERMIT APPLICATION FOR: Electrical
i?,ROPOSED IMF?R01/EM'ENT LOCATI,QN
Address: 2651 MINUTE MAID RD., FORT PIERCE
Legal Description: See attached legal description
Property Tax ID#: 1231-111-0003-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED QESCRIPTION aF 111/t7RK ,'
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Additional work o be perfo—rmed under this permit-eh ec all apply:
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HVAC Gas Tank ❑Gas Piping _Shutters n Doors Windows
L.1 /
W1Electric 0 Plumbing Sprinklers Generator ❑ Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 885.00 Utilities:Sewer E Septic Building Height:
OWNER/,LESEE.J CONTRACTQR IIchmand Elctr'rc lne3
Name J&L Hale LLC Name: Christopher W.Richmond
Address:398 SE Naranja Ave. Company: Richmond Electric Inc.
City: Port St Lucie State:FL Address: 3086 Enterprise Rd.
Zip Code: 34983 Fax: City: Fort Pierce State:FL
Phone No.772-528-1840 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: 17642/EC0001963
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
StPPLENIENTAL CONSTRUCTION LIEN LAW INFORMATION , 3
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.
S
_Signature of wner/Lessee/Agent Signature of G ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF sT LUCIE CO U NTY O F ST LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 2-7"N day of 00"1) 20 L5—by this 29 day of_ FlQr,B 20 15 by
V
CHRISTOPHER*RICHMOND CHRISTOPHER W.RICHMOND
(Name of person acknowledging) (Name of person acknowledging)
(Signaturet9f Notary Public-Staie of Florida) (Signaturegf Notary Public-State of Florida)
Personally Known_X OR Produced Identification Personally Known Y OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. I--®®.(Seal,). Commission No. SS o °""'Q4�_ MOW SINKL
CASEY BIRI&zL�VY� My COMMISSION#EE1�1�78
%' 201—
EXPIRES August 16,2015 (407)998-01s aidok�ryser�ice.wm
Revised 07/15/2014 [(407)398-^ut53 rlcidaNutarySerwice.com
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