HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 1- ln• ���n_
RECEIVED
Building Permit Application JUN 3 2015
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
PROPQSED IIUIPROVEMENT LOCATION_.
..
Address: 6905 DELAND AVE, FORT PIERCE, FL 34951
Legal Description: LAKEWOOD PARK-UNIT 10- BILK 128 LOTS 9 AND 10
Property Tax ID#: 1301-612-0215-000-6 Lot No.9& 10
Site Plan Name: Block No. 128
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION'OF WORK
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CONSTRUCTION INFORM
ATiON
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Additionalwork to De rrormed under t is permit—c ec all appy:
HVAC I_J Gas Tank ❑Gas Piping _Shutters Windows/Doors
❑✓_Electric 0 Plumbing 11 Sprinklers 1:1 Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
oe
Cost of Construction:$ of y so� Utilities: _Sewer ElSeptic Building Height:
OWNER/LESSEE OFELIATCOEL'LO CONTRACTOR R[C., ND;ELECTRIC,INC
.. .
Name OFELIA COELLO Name: CHRISTOPHER W. RICHMOND
Address:6905 DELAND AVE Company: RICHMOND ELECTRIC INC.
City: FORT PIERCE State:FL Address: 3086 ENTERPRISE RD.
Zip Code: 34951 Fax: City: FORT PIERCE State.FL
Phone No.772-480-8947 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.
St3PPLEMENTAL CONSTRUCTION LI, N LAW iNtRMATION
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 thepermit 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 orrecording our Notice of Commencement.
S
_Signature of Owner/lessee gent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF FLORIDA COUNTY OF FLORIDA
The forgoing instrument was acknowledged before me The forging instrument was acknowledged before me
this Is day of 7Sy, e 20 _.by this i day of 7j.v+e 20 lS by
CHRISTOPHER*RICHMOND CHRISTOPHER W.RICHMOND
(Name of person acknowledging) (Name of person acknowledging)
r f
T
(Signature Notary Public-State of- arida) (Signature of tary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission.No. E 1! Fly S at)` ommission No. CE 11 8 'YAU - {&RgEY SINKLEY
= ^Q MY COMM
ISSION#EE11785
*% •� MY COMISSiON#EE11785 y
lr #zv;.• to d ,�August ,2015
9'ff �4 E.XPiRES August 16,2095
Revised 07/15/2014 (407)395-0183 Fia w^!.a�ryService.com
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