HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l(� � � l J Permit Number: (57-10- ()02'�/V.
® RECEIVE
Building Permit Application JUNA5 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
PROPOSED jMPROVENIENT LOCATION „
Address: 1700 Linwood Ave., Fort Pierce, FL 34982
Legal Description: MARAVILLA PLAZA BLK 8 LOTS 10 AND 11
Property Tax[D#: 2421-802-0096-000-0 Lot No. 10-11
Site Plan Name: Block No. 8
Project Name:
Setbacks Front Back: Right Side: Left Side:
QTA(LED DESCR1PTlON OF WORK
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Additionalwork toe e orme un er t is permit–c ec a appy:
HVAC Gas Tank []Gas Piping Shutters Q Windows/Doors
❑✓—Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 1176.00 Utilities:Sewer ElSeptic Building Height:
OWNER/LESSEE JQNAH ANDERSON; CONTRACTOR RICH3MOND ELECTRIC INC
Name JtANDERSON Name: CHRISTOPHER W. RICHMOND
Address:1700 LINWOOD AVE. Company: RICHMOND ELECTRIC INC.
City: FORT PIERCE State:FL Address: 3086 ENTERPRISE RD.
Zip Code: 34982 Fax: City: FORT PIERCE State:FL
Phone No.772-919-5002 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.
SUPPLEMENTAL GONSTR;UCTION LIEN LAIN INF-OR(\/IATtON,
ppli � 7. .
MORTGAGE COMPANY:
.,�.x
� pp MOR PANY: Not
DESIGNER ENGINEER: Not A licable 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 or recording our Notice of Commencement.
4
LY l,�r s
_Signature of Owner/Lesse Agent Signature of Contractor/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 10+h day of _,!U.n e 20 IS by this le",day of _Stn20 fs by
CHRISTOPHER*RICHMOND CHRISTOPHER W.RICHMOND
(Name of person acknowledging) (Name of person acknowledging)
(Signature ofdkotary Public-Stat of Florida) (Signature of ary 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. EE117856 (Seal) Commission No. EE117856
.�•'�� - _ CASEY GINKLEY ;4�µ���. CASEY SiNKLEY
10y COtIUOSSION#EE117856 n r ,-tveiv �.�: ,:
Revised 07/15/2014 EXMRIES August 16,2015 �;°;t :` E%C+NRES August 16,2015
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