HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / 7
Date: 6/24/2015 Permit Number: ol40a .
®
RCCC
C ,V
Building Permit Application
Planning and Development Services JUN 2 6
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
µP:FtOPOSED IIV{PR01/EMENT LOCATIaN
Address: 9901 OKEECHOBEE RD., FORT PIERCE, FL
Legal Description: SEE ATTACHED PROPERTY IDENTIFICATION CARD FOR LEGAL DESCRIPTION
Property Tax ID#: 2327-214-0005-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETA{LED DESCR{PT{ON°'OF WORK
H0(* 120V C IACLA J TO F- LCC71tLc C)ATL Cc3NIYz_LLCn S
6N JA S1 £ E-5 C�tzES . t4 E SAf c- 12WiTs div, 0 L
CONSTRUCTION {N:FORMATION
.
Additional work toe e orme under t is permit—c ec a appy:
HVAC Ei Gas Tank Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing []Sprinklers ❑Generator Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ 1635.00 Utilities:cn Sewer ElSeptic Building Height:
Ni R1 BLFUE;000SE"GRO:WERS; x;CONTRACTOR RICHMOND ELECTRIC INC i
Name BLUE GOOSE GROWERS LLC Name: CHRISTOPHER W. RICHMOND
Address:PO BOX 14709 Company: RICHMOND ELECTRIC INC.
City: FORT PIERCE State:FL Address: 3086 ENTERPRISE RD.
Zip Code: 34979 Fax: City: FORT PIERCE State:FL
Phone No.772-461-3020 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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.
12M
� a s
Signature of wner/Lessee/Agent cv om Signature of C ntractor/License HolderSTATE OF FLORIDA �Ncc
COUNTY OF srLuciE . STATE OF FLORIDAS� COUNTY OF ST LUCIE MThe for oing ins ent was acknowledged before m ¢ 2 The f r oing instr t was acknowledged b ren $
thiso L day of 20//S by Q 0X ~ this day of 20 y
0.
mo
(Name of person acknowledging) : (Name of person acknowledgingorl
) W-Paqp�[
(Signa ure T16tary Pub ic-State of Ff6rida) (Signature of No ry Public-State of Florida)
Personally Known!/ OR Produced Identification Personally Known �OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS